Consolidated CDA (C-CDA)
4.0.0-ballot - STU4 Ballot United States of America flag

This page is part of the CCDA: Consolidated CDA Release (v4.0.0-ballot: CCDA 4.0 Ballot 1) generated with FHIR (HL7® FHIR® Standard) v5.0.0. The current version which supersedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

Logical Model: Policy Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PolicyActivity Version: 4.0.0-ballot
Draft as of 2024-12-20 Computable Name: PolicyActivity
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.61:2024-05-01

A policy activity represents the policy or program providing the coverage. The person for whom payment is being provided (i.e., the patient) is the covered party. The subscriber of the policy or program is represented as a participant that is the holder of the coverage. The payer is represented as the performer of the policy activity. Note that the absence of a Policy Activity Act is not confirmation the patient does not have coverage. A Patient's coverage may not have been documented yet or not known to the healthcare provider.

  • Absence of a Policy Activity Act may mean that the patient has no coverage or the healthcare provider may not know it.
  • A self pay payer type MAY be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs.

Usage:

Formal Views of Template Content

Description of Template, Differentials, Snapshots and how the different presentations work.

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:policy-activity 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Fixed Value: ACT
... @moodCode 1..1 cs Fixed Value: EVN
... code
.... @code 0..1 cs Binding: Payer Type . (preferred)
... 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: completed
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
...... @extension 0..0
..... @typeCode 1..1 cs
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... code 0..1 CE
....... @nullFlavor 0..0
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... name 0..1 ON
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
...... @extension 0..0
..... @typeCode 1..1 cs
..... time 0..1 IVL_TS
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... code 1..1 CE
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
...... @extension 0..0
..... @typeCode 1..1 cs Fixed Value: COV
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... low 0..1 IVXB_TS
...... high 0..1 IVXB_TS
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
should-code-attr: SHOULD contain @code
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
...... addr 0..1 USRealmAddress
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS sdtc:birthTime
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
...... @extension 0..0
..... @typeCode 1..1 cs Fixed Value: HLD
..... time 0..1 IVL_TS
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr 0..1 USRealmAddress
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @typeCode 1..1 cs Fixed Value: REFR
..... act 1..1 AuthorizationActivity
...... @moodCode 1..1 cs EVN
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @typeCode 1..1 cs Fixed Value: REFR
..... act 1..1 Act
...... @classCode 1..1 cs Fixed Value: ACT
...... @moodCode 1..1 cs Fixed Value: DEF
...... id 1..* II Plan identifier
...... text 1..1 ED Name of the plan

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
.... templateId:policy-activity 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @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: EVN
... @negationInd 0..1 bl
... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **GROUP NUMBER**: This is the identifier used to uniquely refer to a specific health insurance plan.
... code 1..1 CD Binding: v3 Code System ActCode (example)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 0..1 cs Binding: Payer Type . (preferred)
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... 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
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... id 0..* II
....... name 0..1 ON
....... telecom 0..* TEL
....... addr 0..* AD
....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
....... asOrganizationPartOf 0..1 OrganizationPartOf
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1 CE Binding: CDARoleCode (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization 0..1 Organization
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
... author 0..* Author
... informant 0..* Informant
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1 cs Binding: CDASetOperator (required)
...... low 0..1 IVXB_TS
...... center 0..1 TS
...... width 0..1 PQ
...... high 0..1 IVXB_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
Binding: CDARoleCode (example)
should-code-attr: SHOULD contain @code
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassRoot (required)
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1 CE Binding: CDAEntityCode (example)
....... quantity 0..* PQ
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1 ED
...... scopingEntity 0..1 Entity
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity
...... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 AuthorizationActivity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
....... templateId:authorization-activity 1..1 II
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
...... @moodCode 1..1 cs EVN
Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: EVN
...... @negationInd 0..1 bl
...... id 1..1 II
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
....... @integrityCheck 0..1 bin
....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1 cs
....... @mediaType 0..1 cs Binding: MediaType (example)
....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... 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
....... thumbnail 0..1 ED
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
81-8951: The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ realmCode 0..* CS
........ typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
......... @assigningAuthorityName 0..1 st
......... @displayable 0..1 bl
......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
......... @extension 1..1 st
........ templateId 0..* II
........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
........ @inversionInd 0..1 bl
........ @contextConductionInd 0..1 bl
........ @negationInd 0..1 bl
........ sequenceNumber 0..1 INT
........ seperatableInd 0..1 BL
........ act 0..1 Act
........ encounter 0..1 Encounter
........ observation 0..1 Observation
........ observationMedia 0..1 ObservationMedia
........ organizer 0..1 Organizer
........ procedure 0..1 Procedure
........ regionOfInterest 0..1 RegionOfInterest
........ substanceAdministration 0..1 SubstanceAdministration
........ supply 0..1 Supply
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 Act
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @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: DEF
...... @negationInd 0..1 bl
...... id 1..* II Plan identifier
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 1..1 ED Name of the plan
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.performer:payer.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:payer.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeCoderequiredFixed Value: COV
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.time.operatorrequiredCDASetOperator
http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeCoderequiredFixed Value: HLD
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:subscriber.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:authorization.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.entryRelationship:authorization.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:plan.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:plan.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:plan.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
: (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
: root.exists() or nullFlavor.exists()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
.... templateId:policy-activity 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @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: EVN
... @negationInd 0..1 bl
... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **GROUP NUMBER**: This is the identifier used to uniquely refer to a specific health insurance plan.
... code 1..1 CD Binding: v3 Code System ActCode (example)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 0..1 cs Binding: Payer Type . (preferred)
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... 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
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... id 0..* II
....... name 0..1 ON
....... telecom 0..* TEL
....... addr 0..* AD
....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
....... asOrganizationPartOf 0..1 OrganizationPartOf
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1 CE Binding: CDARoleCode (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization 0..1 Organization
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
... author 0..* Author
... informant 0..* Informant
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1 cs Binding: CDASetOperator (required)
...... low 0..1 IVXB_TS
...... center 0..1 TS
...... width 0..1 PQ
...... high 0..1 IVXB_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
Binding: CDARoleCode (example)
should-code-attr: SHOULD contain @code
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassRoot (required)
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1 CE Binding: CDAEntityCode (example)
....... quantity 0..* PQ
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1 ED
...... scopingEntity 0..1 Entity
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity
...... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 AuthorizationActivity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
....... templateId:authorization-activity 1..1 II
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
...... @moodCode 1..1 cs EVN
Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: EVN
...... @negationInd 0..1 bl
...... id 1..1 II
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
....... @integrityCheck 0..1 bin
....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1 cs
....... @mediaType 0..1 cs Binding: MediaType (example)
....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... 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
....... thumbnail 0..1 ED
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
81-8951: The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ realmCode 0..* CS
........ typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
......... @assigningAuthorityName 0..1 st
......... @displayable 0..1 bl
......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
......... @extension 1..1 st
........ templateId 0..* II
........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
........ @inversionInd 0..1 bl
........ @contextConductionInd 0..1 bl
........ @negationInd 0..1 bl
........ sequenceNumber 0..1 INT
........ seperatableInd 0..1 BL
........ act 0..1 Act
........ encounter 0..1 Encounter
........ observation 0..1 Observation
........ observationMedia 0..1 ObservationMedia
........ organizer 0..1 Organizer
........ procedure 0..1 Procedure
........ regionOfInterest 0..1 RegionOfInterest
........ substanceAdministration 0..1 SubstanceAdministration
........ supply 0..1 Supply
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 Act
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @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: DEF
...... @negationInd 0..1 bl
...... id 1..* II Plan identifier
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 1..1 ED Name of the plan
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.performer:payer.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:payer.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeCoderequiredFixed Value: COV
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.time.operatorrequiredCDASetOperator
http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeCoderequiredFixed Value: HLD
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:subscriber.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:authorization.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.entryRelationship:authorization.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:plan.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:plan.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:plan.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
: (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
: root.exists() or nullFlavor.exists()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf 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: 18 elements(16 nested mandatory elements)
Fixed: 9 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 2 is sliced based on the values of Act.templateId
  • The element 1 is sliced based on the value of Act.performer
  • The element 1 is sliced based on the value of Act.participant
  • The element 1 is sliced based on the value of Act.entryRelationship

Differential View

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:policy-activity 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Fixed Value: ACT
... @moodCode 1..1 cs Fixed Value: EVN
... code
.... @code 0..1 cs Binding: Payer Type . (preferred)
... 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: completed
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
...... @extension 0..0
..... @typeCode 1..1 cs
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... code 0..1 CE
....... @nullFlavor 0..0
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... name 0..1 ON
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
...... @extension 0..0
..... @typeCode 1..1 cs
..... time 0..1 IVL_TS
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... code 1..1 CE
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
...... @extension 0..0
..... @typeCode 1..1 cs Fixed Value: COV
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... low 0..1 IVXB_TS
...... high 0..1 IVXB_TS
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
should-code-attr: SHOULD contain @code
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
...... addr 0..1 USRealmAddress
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS sdtc:birthTime
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... templateId 1..1 II
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
...... @extension 0..0
..... @typeCode 1..1 cs Fixed Value: HLD
..... time 0..1 IVL_TS
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr 0..1 USRealmAddress
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @typeCode 1..1 cs Fixed Value: REFR
..... act 1..1 AuthorizationActivity
...... @moodCode 1..1 cs EVN
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @typeCode 1..1 cs Fixed Value: REFR
..... act 1..1 Act
...... @classCode 1..1 cs Fixed Value: ACT
...... @moodCode 1..1 cs Fixed Value: DEF
...... id 1..* II Plan identifier
...... text 1..1 ED Name of the plan

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
.... templateId:policy-activity 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @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: EVN
... @negationInd 0..1 bl
... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **GROUP NUMBER**: This is the identifier used to uniquely refer to a specific health insurance plan.
... code 1..1 CD Binding: v3 Code System ActCode (example)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 0..1 cs Binding: Payer Type . (preferred)
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... 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
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... id 0..* II
....... name 0..1 ON
....... telecom 0..* TEL
....... addr 0..* AD
....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
....... asOrganizationPartOf 0..1 OrganizationPartOf
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1 CE Binding: CDARoleCode (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization 0..1 Organization
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
... author 0..* Author
... informant 0..* Informant
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1 cs Binding: CDASetOperator (required)
...... low 0..1 IVXB_TS
...... center 0..1 TS
...... width 0..1 PQ
...... high 0..1 IVXB_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
Binding: CDARoleCode (example)
should-code-attr: SHOULD contain @code
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassRoot (required)
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1 CE Binding: CDAEntityCode (example)
....... quantity 0..* PQ
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1 ED
...... scopingEntity 0..1 Entity
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity
...... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 AuthorizationActivity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
....... templateId:authorization-activity 1..1 II
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
...... @moodCode 1..1 cs EVN
Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: EVN
...... @negationInd 0..1 bl
...... id 1..1 II
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
....... @integrityCheck 0..1 bin
....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1 cs
....... @mediaType 0..1 cs Binding: MediaType (example)
....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... 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
....... thumbnail 0..1 ED
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
81-8951: The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ realmCode 0..* CS
........ typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
......... @assigningAuthorityName 0..1 st
......... @displayable 0..1 bl
......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
......... @extension 1..1 st
........ templateId 0..* II
........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
........ @inversionInd 0..1 bl
........ @contextConductionInd 0..1 bl
........ @negationInd 0..1 bl
........ sequenceNumber 0..1 INT
........ seperatableInd 0..1 BL
........ act 0..1 Act
........ encounter 0..1 Encounter
........ observation 0..1 Observation
........ observationMedia 0..1 ObservationMedia
........ organizer 0..1 Organizer
........ procedure 0..1 Procedure
........ regionOfInterest 0..1 RegionOfInterest
........ substanceAdministration 0..1 SubstanceAdministration
........ supply 0..1 Supply
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 Act
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @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: DEF
...... @negationInd 0..1 bl
...... id 1..* II Plan identifier
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 1..1 ED Name of the plan
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.performer:payer.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:payer.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeCoderequiredFixed Value: COV
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.time.operatorrequiredCDASetOperator
http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeCoderequiredFixed Value: HLD
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:subscriber.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:authorization.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.entryRelationship:authorization.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:plan.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:plan.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:plan.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
: (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
: root.exists() or nullFlavor.exists()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
4537-17139: When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
.... templateId:policy-activity 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1 st Required Pattern: 2024-05-01
... @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: EVN
... @negationInd 0..1 bl
... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **GROUP NUMBER**: This is the identifier used to uniquely refer to a specific health insurance plan.
... code 1..1 CD Binding: v3 Code System ActCode (example)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 0..1 cs Binding: Payer Type . (preferred)
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... 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
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
.... performer:payer 1..1 Performer2 This performer represents the Payer.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity should-code: SHOULD contain code
should-representedOrganization: SHOULD contain representedOrganization
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **PAYER IDENTIFIER**: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization C 0..1 Organization should-name: SHOULD contain name
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... id 0..* II
....... name 0..1 ON
....... telecom 0..* TEL
....... addr 0..* AD
....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
....... asOrganizationPartOf 0..1 OrganizationPartOf
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
.... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... modeCode 0..1 CE
..... assignedEntity C 1..1 AssignedEntity 4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... id 1..* II
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1 CE Binding: CDARoleCode (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: GUAR
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... assignedPerson 0..1 Person
...... representedOrganization 0..1 Organization
...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
XML: patient (urn:hl7-org:sdtc)
....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
XML Namespace: urn:hl7-org:sdtc
... author 0..* Author
... informant 0..* Informant
... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
.... participant:coverage-target C 1..1 Participant2 participant
should-time: SHOULD contain time
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
should-low: SHOULD contain low
should-high: SHOULD contain high
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1 cs Binding: CDASetOperator (required)
...... low 0..1 IVXB_TS
...... center 0..1 TS
...... width 0..1 PQ
...... high 0..1 IVXB_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
should-playingEntity: SHOULD contain playingEntity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **MEMBER IDENTIFIER**: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: **RELATIONSHIP TO SUBSCRIBER**: Records the relationship of a patient to the primary insured person.
Binding: CDARoleCode (example)
should-code-attr: SHOULD contain @code
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
....... @codeSystem 0..1 oid, uuid, ruid
....... @codeSystemName 0..1 st
....... @codeSystemVersion 0..1 st
....... @displayName 0..1 st
....... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1 ED
....... translation 0..* CD
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... realmCode 0..* CS
....... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1 st
....... templateId 0..* II
....... @classCode 0..1 cs Binding: EntityClassRoot (required)
....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1 CE Binding: CDAEntityCode (example)
....... quantity 0..* PQ
....... name 1..1 PN
....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1 ED
...... scopingEntity 0..1 Entity
.... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 1..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1 IVL_TS
..... awarenessCode 0..1 CE
..... participantRole C 1..1 ParticipantRole should-addr: SHOULD contain addr
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: **SUBSCRIBER ID**: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1 CE Binding: CDARoleCode (example)
...... addr 0..1 USRealmAddress
...... telecom 0..* TEL
...... playingDevice 0..1 Device
...... playingEntity 0..1 PlayingEntity
...... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
.... entryRelationship:authorization 0..* EntryRelationship entryRelationship
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 AuthorizationActivity
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... Slices for templateId 1..* II Slice: Unordered, Open by value:root
....... templateId:authorization-activity 1..1 II
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1 st
........ @displayable 0..1 bl
........ @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.1.19
...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
...... @moodCode 1..1 cs EVN
Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: EVN
...... @negationInd 0..1 bl
...... id 1..1 II
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
....... @integrityCheck 0..1 bin
....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1 cs
....... @mediaType 0..1 cs Binding: MediaType (example)
....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... 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
....... thumbnail 0..1 ED
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
81-8951: The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
........ realmCode 0..* CS
........ typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
......... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
......... @assigningAuthorityName 0..1 st
......... @displayable 0..1 bl
......... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
......... @extension 1..1 st
........ templateId 0..* II
........ @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
........ @inversionInd 0..1 bl
........ @contextConductionInd 0..1 bl
........ @negationInd 0..1 bl
........ sequenceNumber 0..1 INT
........ seperatableInd 0..1 BL
........ act 0..1 Act
........ encounter 0..1 Encounter
........ observation 0..1 Observation
........ observationMedia 0..1 ObservationMedia
........ organizer 0..1 Organizer
........ procedure 0..1 Procedure
........ regionOfInterest 0..1 RegionOfInterest
........ substanceAdministration 0..1 SubstanceAdministration
........ supply 0..1 Supply
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 1..1 Act
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... realmCode 0..* CS
...... typeId C 0..1 II II-1: An II instance must have either a root or an nullFlavor.
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1 st
....... @displayable 0..1 bl
....... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1 st
...... templateId 0..* II
...... @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: DEF
...... @negationInd 0..1 bl
...... id 1..* II Plan identifier
...... code 1..1 CD Binding: v3 Code System ActCode (example)
...... text 1..1 ED Name of the plan
...... statusCode 0..1 CS Binding: ActStatus (required)
...... effectiveTime 0..1 IVL_TS
...... priorityCode 0..1 CE Binding: ActPriority (example)
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:policy-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.code.codepreferredPayerType . (a valid code from Source of Payment Typology (https://nahdo.org/sopt)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.performer:payer.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:payer.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:payer.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:payer.assignedEntity.code.codepreferredFinanciallyResponsiblePartyTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.10416
Act.performer:payer.assignedEntity.representedOrganization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:payer.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Act.performer:payer.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.performer:payer.assignedEntity.representedOrganization.standardIndustryClassCodeexampleOrganizationIndustryClassNAICS
http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Act.performer:guarantor.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.typeCoderequiredFixed Value: PRF
http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Act.performer:guarantor.assignedEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.performer:guarantor.assignedEntity.classCoderequiredFixed Value: ASSIGNED
http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Act.performer:guarantor.assignedEntity.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.performer:guarantor.assignedEntity.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.typeCoderequiredFixed Value: COV
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:coverage-target.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:coverage-target.time.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.time.operatorrequiredCDASetOperator
http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Act.participant:coverage-target.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:coverage-target.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.participant:coverage-target.participantRole.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.code.codepreferredCoverageRoleTypeValueSet .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.18877
Act.participant:coverage-target.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:coverage-target.participantRole.playingEntity.classCoderequiredEntityClassRoot
http://terminology.hl7.org/ValueSet/v3-EntityClassRoot
Act.participant:coverage-target.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Act.participant:coverage-target.participantRole.playingEntity.codeexampleCDAEntityCode
http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode
Act.participant:subscriber.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.templateId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.typeCoderequiredFixed Value: HLD
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant:subscriber.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant:subscriber.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant:subscriber.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant:subscriber.participantRole.codeexampleCDARoleCode
http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Act.entryRelationship:authorization.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:authorization.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.templateId:authorization-activity.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:authorization.act.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:authorization.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:authorization.act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.entryRelationship:authorization.act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.entryRelationship:authorization.act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.entryRelationship:authorization.act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.entryRelationship:authorization.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:authorization.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:authorization.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:authorization.act.entryRelationship:target.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:authorization.act.entryRelationship:target.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.typeCoderequiredFixed Value: REFR
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:plan.act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:plan.act.classCoderequiredFixed Value: ACT
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.entryRelationship:plan.act.moodCoderequiredFixed Value: DEF
http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0
Act.entryRelationship:plan.act.codeexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Act.entryRelationship:plan.act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:plan.act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.entryRelationship:plan.act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
4537-8967warningAct.performer:guarantor.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
: assignedPerson.name.exists() or representedOrganization.name.exists()
4537-17139errorActWhen the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
: participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
81-8951errorAct.entryRelationship:authorization.act.entryRelationship:targetThe target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
: (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1errorAct.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeIdAn II instance must have either a root or an nullFlavor.
: root.exists() or nullFlavor.exists()
should-addrwarningAct.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRoleSHOULD contain addr
: addr.exists()
should-codewarningAct.performer:payer.assignedEntitySHOULD contain code
: code.exists()
should-code-attrwarningAct.participant:coverage-target.participantRole.codeSHOULD contain @code
: code.exists()
should-highwarningAct.participant:coverage-target.timeSHOULD contain high
: high.exists()
should-lowwarningAct.participant:coverage-target.timeSHOULD contain low
: low.exists()
should-namewarningAct.performer:payer.assignedEntity.representedOrganizationSHOULD contain name
: name.exists()
should-playingEntitywarningAct.participant:coverage-target.participantRoleSHOULD contain playingEntity
: playingEntity.exists()
should-representedOrganizationwarningAct.performer:payer.assignedEntitySHOULD contain representedOrganization
: representedOrganization.exists()
should-telecomwarningAct.performer:guarantor.assignedEntitySHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningAct.performer:guarantor, Act.participant:coverage-targetSHOULD contain time
: time.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
value-starts-octothorpeerrorAct.entryRelationship:authorization.act.text.referenceIf 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: 18 elements(16 nested mandatory elements)
Fixed: 9 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 2 is sliced based on the values of Act.templateId
  • The element 1 is sliced based on the value of Act.performer
  • The element 1 is sliced based on the value of Act.participant
  • The element 1 is sliced based on the value of Act.entryRelationship

 

Other representations of profile: CSV, Excel