C-CDA on FHIR
2.0.0-ballot - STU 2 Ballot
C-CDA on FHIR
2.0.0-ballot - STU 2 Ballot
This page is part of the C-CDA on FHIR Implementation Guide (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.2.0. For a full list of available versions, see the Directory of published versions
This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to Procedures FHIR → CDA. For guidance on how to read the table below, see Reading the C-CDA ↔ FHIR Mapping Pages
C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Procedure Activity Observation, and Procedure Activity Procedure. Procedure Activity Procedure is the most complete, containing everything the other two contain except Observation.value, and several properties not contained by the others. The C-CDA 2.1 Companion Guide points out that "most vendors successfully and exclusively use the . . . Procedure Activity Procedure," and it then specifies this template for "all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we have only provided a mapping from Procedure Activity Procedure. Procedure Activity Act can use the same mapping to a FHIR Procedure resource because it contains a subset of the fields available in Procedure Activity Procedure. Procedure Activity Observation can be mapped to either a Procedure resource or to an Observation resource using the results mapping (or a combination of the two).
| C-CDA¹ Procedure Activity procedure |
FHIR Procedure |
Transform Steps |
|---|---|---|
| /@negationInd="true" | set status="not-done" | |
| /id | .identifier | CDA id ↔ FHIR identifier |
| /code | .code | CDA coding ↔ FHIR CodeableConcept |
| /statusCode | .status | CDA statusCode → FHIR status |
| /effectiveTime | .performedDateTime | Constraint: Use this when effectiveTime@value is populated CDA ↔ FHIR Time/Dates If no effectiveTime content is provided, put the FHIR [ data-absent-reason] (https://hl7.org/fhir/R4/extension-data-absent-reason.html) extension on the performedDateTime element. |
| /effectiveTime/low | .performedPeriod.start | Constraint: Use this when effectiveTime@value is not populated CDA ↔ FHIR Time/Dates |
| /effectiveTime/high | .performedPeriod.end | Constraint: Use this when effectiveTime@value is not populated CDA ↔ FHIR Time/Dates |
| /targetSiteCode | .bodySite | CDA coding ↔ FHIR CodeableConcept |
| /author | .recorder & Provenance |
CDA ↔ FHIR Provenance If a latest author can be identified, map to .recorder. Any author with a time can be put in Provenance. |
| /performer/assignedEntity | .performer.actor | May map to Practitioner, PractitionerRole, or Organization onBehalfOf should not be used when actor is a Practitioner or PractitionerRole |
| Service Delivery Location /participant[@typeCode="LOC"]/participantRole |
.location | |
| Indication /entryRelationship[@typeCode="RSON"]/observation/value |
.reasonCode | CDA coding ↔ FHIR CodeableConcept |
| Comment Activity /entryRelationship/act[code/@code="48767-8"]/text |
Annotation .note |
See Comment → Annotation |
1. XPath abbrievated for C-CDA Procedure as:
ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure
| CDA Procedure Example | FHIR Procedure Resource |
|---|---|
|
<procedure classCode="PROC" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09" />
<templateId root="2.16.840.1.113883.10.20.22.4.14" />
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.7" extension="545069400001" />
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.7" extension="545069400003" />
<code
code="80146002"
codeSystem="2.16.840.1.113883.6.96"
displayName="Excision of appendix">
<originalText>
<reference value="#_dfcf353c-538f-498a-9a53-80dda209e456" />
</originalText>
<translation
code="0DBJ4ZZ"
codeSystem="2.16.840.1.113883.6.90"
displayName="Excision of appendix, Percutaneous Endoscopic Approach"/>
</code>
<statusCode code="completed" />
<effectiveTime value="20120806"/>
</procedure>
|
{
"resourceType" : "Procedure",
"identifier" : [{
"system" : "urn:oid:1.3.6.1.4.1.22812.3.2009316.3.4.7",
"value" : "545069400001"
},
{
"system" : "urn:oid:1.3.6.1.4.1.22812.3.2009316.3.4.7",
"value" : "545069400003"
}],
"status" : "completed",
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "80146002",
"display" : "Excision of appendix"
},
{
"system" : "http://www.cms.gov/Medicare/Coding/ICD10",
"code" : "0DBJ4ZZ",
"display" : "Excision of appendix, Percutaneous Endoscopic Approach"
}],
"text" : "Excision of appendix"
},
"subject" : {
"reference" : "Patient/CF-patient"
},
"performedDateTime" : "2012-08-06"
}
|
The consensus mapping example developed through multiple vendors are available below:
IG © 2020+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.ccda#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-12-17
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