Consolidated CDA (C-CDA)
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This page is part of the CCDA: Consolidated CDA Release (v3.0.0: CCDA 3.0) 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: HospitalDischargeDiagnosis - Detailed Descriptions

Draft as of 2024-05-18

Definitions for the HospitalDischargeDiagnosis logical model.

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

0. Act
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
2. Act.templateId
Control1..?
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Act.templateId:hospital-discharge-dx
    Slice Namehospital-discharge-dx
    Control1..1
    6. Act.templateId:hospital-discharge-dx.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.33
    8. Act.templateId:hospital-discharge-dx.extension
    Control1..?
    Pattern Value2015-08-01
    10. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-7663).

    Fixed ValueACT
    12. Act.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-7664).

    Fixed ValueEVN
    14. Act.code
    Comments

    SHALL contain exactly one [1..1] code (CONF:1198-19147).

    16. Act.code.code
    Comments

    This code SHALL contain exactly one [1..1] @code="11535-2" Hospital discharge diagnosis (CONF:1198-19148).

    Control1..?
    Pattern Value11535-2
    18. Act.code.codeSystem
    Comments

    This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32163).

    Control1..?
    Pattern Value2.16.840.1.113883.6.1
    20. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    22. Act.text.reference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    24. Act.entryRelationship
    Control1..?
    SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ observation
    • 26. Act.entryRelationship:problemObservation
      Slice NameproblemObservation
      Comments

      SHALL contain at least one [1..*] entryRelationship (CONF:1198-7666) such that it

      Control1..*
      28. Act.entryRelationship:problemObservation.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="SUBJ" Has Subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-7667).

      Fixed ValueSUBJ
      30. Act.entryRelationship:problemObservation.observation
      Comments

      SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15536).

      Control1..?
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)

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

      0. Act
      Definition

      Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


      Base definition for all types defined in FHIR type system.

      ShortBase for all types and resources
      Control10..1*
      Is Modifierfalse
      Logical ContainerClinicalDocument (CDA Class)
      ValidationInstance of this type are validated by templateId
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
      Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
      2. Act.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control1..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 4. Act.templateId:hospital-discharge-dx
        Slice Namehospital-discharge-dx
        Definition

        When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        6. Act.templateId:hospital-discharge-dx.root
        Definition

        A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Pattern Value2.16.840.1.113883.10.20.22.4.33
        8. Act.templateId:hospital-discharge-dx.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        Pattern Value2015-08-01
        10. Act.classCode
        Comments

        SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-7663).

        Control1..1
        BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueACT
        12. Act.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-7664).

        Control1..1
        BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueEVN
        14. Act.code
        Comments

        SHALL contain exactly one [1..1] code (CONF:1198-19147).

        Control1..1
        BindingFor example codes, see v3 Code System ActCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        16. Act.code.code
        Definition

        The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

        Comments

        This code SHALL contain exactly one [1..1] @code="11535-2" Hospital discharge diagnosis (CONF:1198-19148).

        Control1..1
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode
        Pattern Value11535-2
        18. Act.code.codeSystem
        Definition

        Specifies the code system that defines the code.

        Comments

        This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32163).

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System
        Pattern Value2.16.840.1.113883.6.1
        20. Act.text
        ShortSHOULD reference the portion of section narrative text corresponding to this entry
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        22. Act.text.reference
        Definition

        A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
        LabelReference
        Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
        24. Act.entryRelationship
        Control1..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
        SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ observation
        • 26. Act.entryRelationship:problemObservation
          Slice NameproblemObservation
          Comments

          SHALL contain at least one [1..*] entryRelationship (CONF:1198-7666) such that it

          Control1..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
          28. Act.entryRelationship:problemObservation.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="SUBJ" Has Subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-7667).

          Control1..1
          BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
          (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValueSUBJ
          30. Act.entryRelationship:problemObservation.observation
          Definition

          Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

          ShortBase for all types and resources
          Comments

          SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15536).

          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)
          Is Modifierfalse
          Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
          should-author: SHOULD contain author (author.exists())

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

          0. Act
          Definition

          Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

          ShortBase for all types and resources
          Control1..1
          Is Modifierfalse
          Logical ContainerClinicalDocument (CDA Class)
          ValidationInstance of this type are validated by templateId
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
          Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
          2. Act.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          4. Act.realmCode
          Definition

          When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          6. Act.typeId
          Definition

          When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          8. Act.typeId.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          10. Act.typeId.assigningAuthorityName
          Definition

          A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          12. Act.typeId.displayable
          Definition

          Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          14. Act.typeId.root
          Definition

          Identifies the type as an HL7 Registered model

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Fixed Value2.16.840.1.113883.1.3
          16. Act.typeId.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          18. Act.templateId
          Definition

          When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

          Control1..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ root
          • value @ extension
          • 20. Act.templateId:hospital-discharge-dx
            Slice Namehospital-discharge-dx
            Definition

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            22. Act.templateId:hospital-discharge-dx.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            24. Act.templateId:hospital-discharge-dx.assigningAuthorityName
            Definition

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelAssigning Authority Name
            26. Act.templateId:hospital-discharge-dx.displayable
            Definition

            Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplayable
            28. Act.templateId:hospital-discharge-dx.root
            Definition

            A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelRoot
            Pattern Value2.16.840.1.113883.10.20.22.4.33
            30. Act.templateId:hospital-discharge-dx.extension
            Definition

            A character string as a unique identifier within the scope of the identifier root.

            Control1..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExtension
            Pattern Value2015-08-01
            32. Act.classCode
            Comments

            SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-7663).

            Control1..1
            BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValueACT
            34. Act.moodCode
            Comments

            SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-7664).

            Control1..1
            BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValueEVN
            36. Act.negationInd
            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            38. Act.id
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            40. Act.code
            Comments

            SHALL contain exactly one [1..1] code (CONF:1198-19147).

            Control1..1
            BindingFor example codes, see v3 Code System ActCode
            (example to http://terminology.hl7.org/ValueSet/v3-ActCode)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            42. Act.code.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            44. Act.code.code
            Definition

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            Comments

            This code SHALL contain exactly one [1..1] @code="11535-2" Hospital discharge diagnosis (CONF:1198-19148).

            Control1..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            Pattern Value11535-2
            46. Act.code.codeSystem
            Definition

            Specifies the code system that defines the code.

            Comments

            This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32163).

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            Pattern Value2.16.840.1.113883.6.1
            48. Act.code.codeSystemName
            Definition

            The common name of the coding system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            50. Act.code.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            52. Act.code.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            54. Act.code.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            56. Act.code.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            58. Act.code.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            60. Act.code.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            62. Act.code.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the " xsi:typeattribute.
            LabelTranslation
            64. Act.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            66. Act.text.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            68. Act.text.compression
            Definition

            Indicates whether the raw byte data is compressed, and what compression algorithm was used.

            Control0..1
            BindingThe codes SHALL be taken from CDACompressionAlgorithm
            (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCompression
            70. Act.text.integrityCheck
            Definition

            The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

            Control0..1
            Typebase64Binary(bin: Binary Data)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check
            72. Act.text.integrityCheckAlgorithm
            Definition

            Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

            Control0..1
            BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check Algorithm
            74. Act.text.language
            Definition

            For character based information the language property specifies the human language of the text.

            Control0..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelLanguage
            76. Act.text.mediaType
            Definition

            Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

            Control0..1
            BindingFor example codes, see MediaType
            (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelMedia Type
            78. Act.text.representation
            Control0..1
            BindingThe codes SHALL be taken from CDABinaryDataEncoding
            (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            80. Act.text.xmlText
            Definition

            Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

            ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
            Comments

            This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as unadorned text.
            82. Act.text.reference
            Definition

            A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
            LabelReference
            Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
            84. Act.text.thumbnail
            Definition

            An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelThumbnail
            86. Act.statusCode
            Control0..1
            BindingThe codes SHALL be taken from ActStatus
            (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            88. Act.effectiveTime
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
            90. Act.priorityCode
            Control0..1
            BindingFor example codes, see ActPriority
            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            92. Act.languageCode
            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            94. Act.subject
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
            96. Act.specimen
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
            98. Act.performer
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
            100. Act.author
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
            102. Act.informant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
            104. Act.participant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
            106. Act.entryRelationship
            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
            SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ observation
            • 108. Act.entryRelationship:problemObservation
              Slice NameproblemObservation
              Comments

              SHALL contain at least one [1..*] entryRelationship (CONF:1198-7666) such that it

              Control1..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              110. Act.entryRelationship:problemObservation.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              112. Act.entryRelationship:problemObservation.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              114. Act.entryRelationship:problemObservation.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              116. Act.entryRelationship:problemObservation.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              118. Act.entryRelationship:problemObservation.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              120. Act.entryRelationship:problemObservation.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              122. Act.entryRelationship:problemObservation.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              124. Act.entryRelationship:problemObservation.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              126. Act.entryRelationship:problemObservation.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              128. Act.entryRelationship:problemObservation.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="SUBJ" Has Subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-7667).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueSUBJ
              130. Act.entryRelationship:problemObservation.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              132. Act.entryRelationship:problemObservation.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              134. Act.entryRelationship:problemObservation.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              136. Act.entryRelationship:problemObservation.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              138. Act.entryRelationship:problemObservation.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              140. Act.entryRelationship:problemObservation.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              142. Act.entryRelationship:problemObservation.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              144. Act.entryRelationship:problemObservation.observation
              Definition

              Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

              ShortBase for all types and resources
              Comments

              SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15536).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)
              Is Modifierfalse
              Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
              should-author: SHOULD contain author (author.exists())
              146. Act.entryRelationship:problemObservation.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              148. Act.entryRelationship:problemObservation.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              150. Act.entryRelationship:problemObservation.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              152. Act.entryRelationship:problemObservation.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              154. Act.entryRelationship:problemObservation.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              156. Act.entryRelationship:problemObservation.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              158. Act.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              160. Act.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              162. Act.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              164. Act.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.