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

This page is part of the CCDA: Consolidated CDA Release (v4.0.0: CCDA 4.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Logical Model: Smoking Status

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/SmokingStatus Version: 4.0.0
Draft as of 2025-06-20 Computable Name: SmokingStatus
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.511:2024-05-01

This template represents a patient's smoking status. It is a combination and replacement of the two previous templates Smoking Status - Meaningful Use and Tobacco Use, and it aligns with the US Core Smoking Status profile.

When the code represents a quantifiable observation (such as Cigarette pack-years - 401201003), the value may be a Physical Quantity. When the code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded.

Regarding effectiveTime: some values in the Tobacco Use value set represent temporal meanings (e.g. 266919005 - Never smoked tobacco) and should correspond to a single timestamp representing when the observation was true. Other codes, such as 59978006 - Cigar smoker, may be represented with a single timestamp or a time range indicating when the patient began smoking and when they stopped.

Usages:

Changes since version 3.0.0:

  • No changes

    • Formal Views of Template Content

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

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:tobacco-use 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: OBS
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @code 1..1 cs
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... effectiveTime 1..1 IVL_TS
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3

    Constraints

    IdGradePath(s)DetailsRequirements
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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, value:extension
    .... templateId:tobacco-use 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: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs
    .... @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
    ... derivationExpr 0..1 ST
    ... 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 Constraints: value-starts-octothorpe
    .... 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 1..1 IVL_TS
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    .... @operator 0..1 cs Binding: CDASetOperator (required)
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... center 0..1 TS
    .... width 0..1 PQ
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... repeatNumber 0..1 IVL_INT
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive
    ..... @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
    ... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
    ... methodCode 0..* CE Binding: ObservationMethod (example)
    ... targetSiteCode 0..* CD
    ... 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)
    ... referenceRange 0..* InfrastructureRoot
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 0..1 cs Binding: CDAActRelationshipType (required)
    Fixed Value: REFV
    .... observationRange 1..1 ObservationRange
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.templateId:tobacco-use.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Observation.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Observation.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Observation.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Observation.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Observation.value:coded.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3
    Observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorObservation.typeId, Observation.referenceRange.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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, value:extension
    .... templateId:tobacco-use 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: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs
    .... @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
    ... derivationExpr 0..1 ST
    ... 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 Constraints: value-starts-octothorpe
    .... 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 1..1 IVL_TS
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    .... @operator 0..1 cs Binding: CDASetOperator (required)
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... center 0..1 TS
    .... width 0..1 PQ
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... repeatNumber 0..1 IVL_INT
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive
    ..... @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
    ... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
    ... methodCode 0..* CE Binding: ObservationMethod (example)
    ... targetSiteCode 0..* CD
    ... 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)
    ... referenceRange 0..* InfrastructureRoot
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 0..1 cs Binding: CDAActRelationshipType (required)
    Fixed Value: REFV
    .... observationRange 1..1 ObservationRange
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.templateId:tobacco-use.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Observation.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Observation.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Observation.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Observation.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Observation.value:coded.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3
    Observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorObservation.typeId, Observation.referenceRange.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 Observation

    Summary

    Mandatory: 10 elements(1 nested mandatory element)
    Fixed: 3 elements

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Observation.templateId
    • The element 1 is sliced based on the value of Observation.value (Closed)

    Differential View

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:tobacco-use 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: OBS
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @code 1..1 cs
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... effectiveTime 1..1 IVL_TS
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3

    Constraints

    IdGradePath(s)DetailsRequirements
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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, value:extension
    .... templateId:tobacco-use 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: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs
    .... @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
    ... derivationExpr 0..1 ST
    ... 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 Constraints: value-starts-octothorpe
    .... 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 1..1 IVL_TS
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    .... @operator 0..1 cs Binding: CDASetOperator (required)
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... center 0..1 TS
    .... width 0..1 PQ
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... repeatNumber 0..1 IVL_INT
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive
    ..... @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
    ... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
    ... methodCode 0..* CE Binding: ObservationMethod (example)
    ... targetSiteCode 0..* CD
    ... 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)
    ... referenceRange 0..* InfrastructureRoot
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 0..1 cs Binding: CDAActRelationshipType (required)
    Fixed Value: REFV
    .... observationRange 1..1 ObservationRange
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.templateId:tobacco-use.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Observation.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Observation.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Observation.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Observation.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Observation.value:coded.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3
    Observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorObservation.typeId, Observation.referenceRange.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 & Constraints    Filter: Filtersdoco
    .. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, coded-value
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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, value:extension
    .... templateId:tobacco-use 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: 2.16.840.1.113883.10.20.22.4.511
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs
    .... @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
    ... derivationExpr 0..1 ST
    ... 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 Constraints: value-starts-octothorpe
    .... 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 1..1 IVL_TS
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
    Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    .... @operator 0..1 cs Binding: CDASetOperator (required)
    .... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    .... center 0..1 TS
    .... width 0..1 PQ
    .... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... repeatNumber 0..1 IVL_INT
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Slice: Unordered, Closed by type:$this
    .... value CD
    .... value REAL
    .... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
    .... value:coded 0..1 CD
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive
    ..... @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
    ... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
    ... methodCode 0..* CE Binding: ObservationMethod (example)
    ... targetSiteCode 0..* CD
    ... 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)
    ... referenceRange 0..* InfrastructureRoot
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 0..1 cs Binding: CDAActRelationshipType (required)
    Fixed Value: REFV
    .... observationRange 1..1 ObservationRange
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.templateId:tobacco-use.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Observation.moodCoderequiredFixed Value: EVN
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Observation.coderequiredSmokingStatusType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
    Observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Observation.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Observation.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.effectiveTime.operatorrequiredCDASetOperator
    http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
    Observation.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Observation.value:coded.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.value:coded.coderequiredSmokingStatusComprehensive .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3
    Observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorObservation.typeId, Observation.referenceRange.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
    : (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
    should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorObservation.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 Observation

    Summary

    Mandatory: 10 elements(1 nested mandatory element)
    Fixed: 3 elements

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Observation.templateId
    • The element 1 is sliced based on the value of Observation.value (Closed)

     

    Other representations of profile: CSV, Excel