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: Indication - Detailed Descriptions

Draft as of 2024-05-18

Definitions for the Indication logical model.

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

0. Observation
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())
should-effectiveTime: SHOULD contain effectiveTime (effectiveTime.exists())
indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists())))
2. Observation.templateId
Control1..?
SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Observation.templateId:indication
    Slice Nameindication
    Control1..1
    6. Observation.templateId:indication.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.19
    8. Observation.templateId:indication.extension
    Control1..?
    Pattern Value2023-05-01
    10. Observation.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-7480).

    Fixed ValueOBS
    12. Observation.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-7481).

    Fixed ValueEVN
    14. Observation.id
    ShortIf the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.
    Comments

    SHALL contain at least one [1..*] id (CONF:4537-7483).

    Control1..?
    16. Observation.code
    Comments

    SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1.

    BindingThe codes SHOULD be taken from Problem Type
    (preferred to https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1)
    18. Observation.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    20. Observation.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('#'))
    22. Observation.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).

    Control1..?
    24. Observation.statusCode.code
    Comments

    This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19105).

    Control1..?
    Fixed Valuecompleted
    26. Observation.effectiveTime
    Comments

    SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).

    28. Observation.value
    ShortIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
    Comments

    MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.

    Control0..1
    BindingThe codes SHOULD be taken from US Core Condition Codes
    (preferred to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/SC

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

    0. 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.


    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())
    should-effectiveTime: SHOULD contain effectiveTime (effectiveTime.exists())
    indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists())))
    2. Observation.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 Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ root
    • value @ extension
    • 4. Observation.templateId:indication
      Slice Nameindication
      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. Observation.templateId:indication.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 Value2.16.840.1.113883.10.20.22.4.19
      8. Observation.templateId:indication.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 Value2023-05-01
      10. Observation.classCode
      Comments

      SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-7480).

      Control1..1
      BindingThe codes SHALL be taken from CDAActClassObservation
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
      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 ValueOBS
      12. Observation.moodCode
      Comments

      SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-7481).

      Control1..1
      BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
      (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|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. Observation.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortIf the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.Logical id of this artifact
      Comments

      SHALL contain at least one [1..*] id (CONF:4537-7483).


      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control10..*1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
      Is Modifierfalse
      16. Observation.code
      Definition

      Describes what was observed. Sometimes this is called the observation "name".

      ShortType of observation (code / type)
      Comments

      SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1.


      All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

      Control1..1
      This element is affected by the following invariants: obs-7
      BindingThe codes SHOULD be taken from For example codes, see Problem Typehttp://hl7.org/fhir/ValueSet/observation-codes
      (preferred to https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
      Is Modifierfalse
      XML FormatThe type of this property is determined using the " xsi:typeattribute.
      Requirements

      Knowing what kind of observation is being made is essential to understanding the observation.

      Alternate NamesName
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Observation.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortSHOULD reference the portion of section narrative text corresponding to this entryText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
      Is Modifierfalse
      XML FormatThe type of this property is determined using the " xsi:typeattribute.
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Observation.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('#'))
      22. Observation.statusCode
      Comments

      SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).

      Control1..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
      24. Observation.statusCode.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 statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19105).

      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
      Fixed Valuecompleted
      26. Observation.statusCode.codeSystem
      Definition

      Specifies the code system that defines the code.

      Control0..0
      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
      28. Observation.statusCode.codeSystemName
      Definition

      The common name of the coding system.

      Control0..0
      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
      30. Observation.statusCode.codeSystemVersion
      Definition

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

      Control0..0
      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
      32. Observation.statusCode.displayName
      Definition

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

      Control0..0
      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
      34. Observation.statusCode.originalText
      Definition

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

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
      LabelOriginal Text
      36. Observation.statusCode.qualifier
      Definition

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

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
      LabelQualifier
      38. Observation.statusCode.translation
      Definition

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

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatThe type of this property is determined using the " xsi:typeattribute.
      LabelTranslation
      40. Observation.effectiveTime
      Comments

      SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
      42. Observation.value
      ShortIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
      Comments

      MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.

      Control0..1
      BindingThe codes SHOULD be taken from US Core Condition Codes
      (preferred to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatThe type of this property is determined using the " xsi:typeattribute.

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

      0. 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
      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())
      should-effectiveTime: SHOULD contain effectiveTime (effectiveTime.exists())
      indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists())))
      2. Observation.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. Observation.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. Observation.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. Observation.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. Observation.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. Observation.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. Observation.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. Observation.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. Observation.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 Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 20. Observation.templateId:indication
        Slice Nameindication
        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. Observation.templateId:indication.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. Observation.templateId:indication.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. Observation.templateId:indication.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. Observation.templateId:indication.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 Value2.16.840.1.113883.10.20.22.4.19
        30. Observation.templateId:indication.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 Value2023-05-01
        32. Observation.classCode
        Comments

        SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-7480).

        Control1..1
        BindingThe codes SHALL be taken from CDAActClassObservation
        (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
        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 ValueOBS
        34. Observation.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-7481).

        Control1..1
        BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|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. Observation.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. Observation.id
        ShortIf the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.
        Comments

        SHALL contain at least one [1..*] id (CONF:4537-7483).

        Control1..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        40. Observation.code
        Comments

        SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1.

        Control1..1
        BindingThe codes SHOULD be taken from Problem Type
        (preferred to https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        XML FormatThe type of this property is determined using the " xsi:typeattribute.
        42. Observation.derivationExpr
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
        44. Observation.text
        ShortSHOULD reference the portion of section narrative text corresponding to this entry
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        XML FormatThe type of this property is determined using the " xsi:typeattribute.
        46. Observation.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
        48. Observation.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
        50. Observation.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
        52. Observation.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
        54. Observation.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
        56. Observation.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
        58. Observation.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.
        60. Observation.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.
        62. Observation.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('#'))
        64. Observation.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
        66. Observation.statusCode
        Comments

        SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).

        Control1..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
        68. Observation.statusCode.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
        70. Observation.statusCode.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 statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19105).

        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
        Fixed Valuecompleted
        72. Observation.statusCode.codeSystem
        Definition

        Specifies the code system that defines the code.

        Control0..0
        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
        74. Observation.statusCode.codeSystemName
        Definition

        The common name of the coding system.

        Control0..0
        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
        76. Observation.statusCode.codeSystemVersion
        Definition

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

        Control0..0
        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
        78. Observation.statusCode.displayName
        Definition

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

        Control0..0
        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
        80. Observation.statusCode.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.
        82. Observation.statusCode.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.
        84. Observation.statusCode.originalText
        Definition

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

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        LabelOriginal Text
        86. Observation.statusCode.qualifier
        Definition

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

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
        LabelQualifier
        88. Observation.statusCode.translation
        Definition

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

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        XML FormatThe type of this property is determined using the " xsi:typeattribute.
        LabelTranslation
        90. Observation.effectiveTime
        Comments

        SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
        92. Observation.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
        94. Observation.repeatNumber
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
        96. Observation.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
        98. Observation.value
        ShortIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
        Comments

        MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.

        Control0..1
        BindingThe codes SHOULD be taken from US Core Condition Codes
        (preferred to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        XML FormatThe type of this property is determined using the " xsi:typeattribute.
        100. Observation.interpretationCode
        Control0..*
        BindingThe codes SHALL be taken from CDAObservationInterpretation
        (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        102. Observation.methodCode
        Control0..*
        BindingFor example codes, see ObservationMethod
        (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        104. Observation.targetSiteCode
        Definition

        Drawn from concept domain ActSite

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        106. Observation.subject
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
        108. Observation.specimen
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
        110. Observation.performer
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
        112. Observation.author
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
        114. Observation.informant
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
        116. Observation.participant
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
        118. Observation.entryRelationship
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
        120. Observation.reference
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
        122. Observation.precondition
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
        124. Observation.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.
        126. Observation.referenceRange
        Definition

        Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
        128. Observation.referenceRange.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
        130. Observation.referenceRange.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
        132. Observation.referenceRange.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
        134. Observation.referenceRange.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
        136. Observation.referenceRange.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
        138. Observation.referenceRange.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
        140. Observation.referenceRange.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
        142. Observation.referenceRange.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
        144. Observation.referenceRange.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
        146. Observation.referenceRange.typeCode
        Control0..1
        BindingThe codes SHALL be taken from CDAActRelationshipType
        (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
        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 ValueREFV
        148. Observation.referenceRange.observationRange
        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
        150. Observation.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.