Note Activity - Definitions - Consolidated CDA (C-CDA) v3.0.0

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: NoteActivity - Detailed Descriptions

Draft as of 2024-05-18

Definitions for the NoteActivity logical model.

Differential Elements Table
Key Elements Table
Snapshot Elements Table

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

0. Act
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
2. Act.templateId
Control	1..?
Slicing	This 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:note-activity
Slice Name	note-activity
Control	1..1
6. Act.templateId:note-activity.root
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.22.4.202`
8. Act.templateId:note-activity.extension
Control	1..?
Pattern Value	`2016-11-01`
10. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).
Fixed Value	`ACT`
12. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).
Fixed Value	`EVN`
14. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:3250-16895).
Invariants	should-translation: SHOULD contain translation (`translation.exists()`)
16. Act.code.code
Comments	This code SHALL contain exactly one [1..1] @code="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).
Control	1..?
Pattern Value	`34109-9`
18. Act.code.codeSystem
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" LOINC (CONF:3250-16941).
Control	1..?
Pattern Value	`2.16.840.1.113883.6.1`
20. Act.code.translation
Short	If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942).
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).
Binding	The codes SHOULD be taken from Note Types (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68`)
22. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Comments	SHALL contain exactly one [1..1] text (CONF:3250-16896).
Control	1..?
Invariants	3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (`mediaType.exists() implies (representation = 'B64' and xmlText.exists())`)
24. Act.text.mediaType
Short	If the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
Comments	This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).
Binding	The codes SHOULD be taken from SupportedFileFormats (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1`)
26. Act.text.reference
Comments	This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).
Control	1..?
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
28. Act.text.reference.nullFlavor
Short	The note activity must reference human-readable content in the narrative, so this reference must not be null.
Comments	This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).
Control	0..0
30. Act.text.reference.value
Comments	This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).
Control	1..?
32. Act.statusCode
Short	Indicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).
Control	1..?
34. Act.effectiveTime
Short	The effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).
Control	1..?
Invariants	should-value-att: SHOULD contain @value (`value.exists()`)
36. Act.effectiveTime.value
Comments	This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).
38. Act.author
Short	Represents the person(s) who wrote the note.
Comments	SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
40. Act.participant
Comments	MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it
Slicing	This element introduces a set of slices on `Act.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
42. Act.participant:legalAuthenticator
Slice Name	legalAuthenticator
Short	Represents the person(s) legally responsible for the contents of the note.
Control	0..*
44. Act.participant:legalAuthenticator.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).
Fixed Value	`LA`
46. Act.participant:legalAuthenticator.time
Short	Indicates the time of signing the note.
Comments	SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
48. Act.participant:legalAuthenticator.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).
Invariants	3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
50. Act.participant:legalAuthenticator.participantRole.id
Short	This may be the ID of the note author. If so, no additional information in this participant is required.
Comments	This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).
Control	1..?
52. Act.participant:legalAuthenticator.participantRole.playingEntity
Comments	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).
54. Act.participant:legalAuthenticator.participantRole.playingEntity.name
Comments	The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
56. Act.entryRelationship
Comments	SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ encounter
58. Act.entryRelationship:encounter
Slice Name	encounter
Short	Links the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
Control	0..*
60. Act.entryRelationship:encounter.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).
Fixed Value	`COMP`
62. Act.entryRelationship:encounter.inversionInd
Comments	SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).
Control	1..?
Fixed Value	`true`
64. Act.entryRelationship:encounter.negationInd
Short	To communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
Comments	MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).
66. Act.entryRelationship:encounter.encounter
Comments	SHALL contain exactly one [1..1] encounter (CONF:3250-16908).
Control	1..?
68. Act.entryRelationship:encounter.encounter.id
Comments	This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).
Control	1..?
Invariants	3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
70. Act.reference
Comments	MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it
Slicing	This element introduces a set of slices on `Act.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ externalDocument
72. Act.reference:externalDocument
Slice Name	externalDocument
Short	Represents an unstructured C-CDA document containing the original contents of the note in the original format.
Control	0..*
74. Act.reference:externalDocument.externalDocument
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).
Control	1..?
Invariants	should-code: SHOULD contain code (`code.exists()`)
76. Act.reference:externalDocument.externalDocument.id
Comments	This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).
Control	1..1
78. Act.reference:externalDocument.externalDocument.code
Comments	This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

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.
Short	Base for all types and resources
Control	10..1*
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-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
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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:note-activity
Slice Name	note-activity
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
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
6. Act.templateId:note-activity.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.202`
8. Act.templateId:note-activity.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2016-11-01`
10. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).
Control	1..1
Binding	The codes SHALL be taken from XActClassDocumentEntryAct (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ACT`
12. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).
Control	1..1
Binding	The codes SHALL be taken from XDocumentActMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
14. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:3250-16895).
Control	1..1
Binding	For example codes, see v3 Code System ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
Invariants	should-translation: SHOULD contain translation (`translation.exists()`)
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="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`34109-9`
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" LOINC (CONF:3250-16941).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
20. Act.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Short	If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942).
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).
Control	0..*
Binding	The codes SHOULD be taken from Note Types (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the " `xsi:type`attribute.
Label	Translation
22. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Comments	SHALL contain exactly one [1..1] text (CONF:3250-16896).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Invariants	3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (`mediaType.exists() implies (representation = 'B64' and xmlText.exists())`)
24. Act.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Short	If the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
Comments	This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).
Control	0..1
Binding	The codes SHOULD be taken from SupportedFileFormats (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
26. 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.
Comments	This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
28. Act.text.reference.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Short	The note activity must reference human-readable content in the narrative, so this reference must not be null.
Comments	This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).
Control	0..0
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
30. Act.text.reference.value
Comments	This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).
Control	1..1
Type	url(url: Universal Resource Locator)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
32. Act.statusCode
Short	Indicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
34. Act.effectiveTime
Short	The effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
Invariants	should-value-att: SHOULD contain @value (`value.exists()`)
36. Act.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Comments	This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
38. Act.author
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.
Short	Represents the person(s) who wrote the note.
Comments	SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
40. Act.participant
Comments	MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on `Act.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
42. Act.participant:legalAuthenticator
Slice Name	legalAuthenticator
Short	Represents the person(s) legally responsible for the contents of the note.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
44. Act.participant:legalAuthenticator.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`LA`
46. Act.participant:legalAuthenticator.time
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Short	Indicates the time of signing the note.
Comments	SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
Is Modifier	false
Invariants	ivl-ts-center: Center cannot co-exist with low or high (`center.empty() or (low.empty() and high.empty())`) ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. (`value.exists() implies value.toString().length() >= 10`) ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. (`value.exists() implies value.toString().length() > 10`)
48. Act.participant:legalAuthenticator.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
50. Act.participant:legalAuthenticator.participantRole.id
Short	This may be the ID of the note author. If so, no additional information in this participant is required.
Comments	This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
52. Act.participant:legalAuthenticator.participantRole.playingEntity
Comments	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
54. Act.participant:legalAuthenticator.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Short	Base for all types and resources
Comments	The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifier	false
Invariants	pn-no-ls: No PN name part may have a qualifier of LS. (`(item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).where(qualifier.where($this = 'LS').exists()).empty()`) 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (`conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()`) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (`item.xmlText.exists() implies (item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).empty()`)
56. Act.entryRelationship
Comments	SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ encounter
58. Act.entryRelationship:encounter
Slice Name	encounter
Short	Links the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
60. Act.entryRelationship:encounter.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`COMP`
62. Act.entryRelationship:encounter.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.
Comments	SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).
Control	1..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`true`
64. Act.entryRelationship:encounter.negationInd
Short	To communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
Comments	MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
66. Act.entryRelationship:encounter.encounter
Comments	SHALL contain exactly one [1..1] encounter (CONF:3250-16908).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
68. Act.entryRelationship:encounter.encounter.classCode
Control	1..1
Binding	The codes SHALL be taken from CDAActClass (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClass`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ENC`
70. Act.entryRelationship:encounter.encounter.moodCode
Control	1..1
Binding	The codes SHALL be taken from XDocumentEncounterMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
72. Act.entryRelationship:encounter.encounter.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short	Logical id of this artifact
Comments	This encounter SHALL contain at least one [1..*] id (CONF:3250-16909). 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.
Control	10..*1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IIid
Is Modifier	false
Invariants	3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
74. Act.reference
Comments	MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
Slicing	This element introduces a set of slices on `Act.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ externalDocument
76. Act.reference:externalDocument
Slice Name	externalDocument
Short	Represents an unstructured C-CDA document containing the original contents of the note in the original format.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
78. Act.reference:externalDocument.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
80. Act.reference:externalDocument.externalDocument
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
Invariants	should-code: SHOULD contain code (`code.exists()`)
82. Act.reference:externalDocument.externalDocument.id
Comments	This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
84. Act.reference:externalDocument.externalDocument.code
Comments	This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).
Control	0..1
Binding	For example codes, see FHIRDocumentTypeCodes (example to `http://hl7.org/fhir/ValueSet/doc-typecodes`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD

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.
Short	Base for all types and resources
Control	1..1
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-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.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional 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
Control	0..*
Type	http://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.
Control	0..1
Type	http://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.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional 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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning 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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Act.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Act.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
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
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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:note-activity
Slice Name	note-activity
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
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Act.templateId:note-activity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Act.templateId:note-activity.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Act.templateId:note-activity.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Act.templateId:note-activity.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.202`
30. Act.templateId:note-activity.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2016-11-01`
32. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).
Control	1..1
Binding	The codes SHALL be taken from XActClassDocumentEntryAct (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ACT`
34. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).
Control	1..1
Binding	The codes SHALL be taken from XDocumentActMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
36. Act.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
38. Act.id
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
40. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:3250-16895).
Control	1..1
Binding	For example codes, see v3 Code System ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
Invariants	should-translation: SHOULD contain translation (`translation.exists()`)
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.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional 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="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`34109-9`
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" LOINC (CONF:3250-16941).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
48. Act.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
50. Act.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code 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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display 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.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSet`.
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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSetVersion`.
58. Act.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
60. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
62. Act.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Short	If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942).
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).
Control	0..*
Binding	The codes SHOULD be taken from Note Types (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the " `xsi:type`attribute.
Label	Translation
64. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Comments	SHALL contain exactly one [1..1] text (CONF:3250-16896).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Invariants	3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (`mediaType.exists() implies (representation = 'B64' and xmlText.exists())`)
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.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
68. Act.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
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.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity 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.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
74. Act.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
76. Act.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Short	If the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
Comments	This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).
Control	0..1
Binding	The codes SHOULD be taken from SupportedFileFormats (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
78. Act.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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.)
Short	Allows 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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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.
Comments	This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-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.reference.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Short	The note activity must reference human-readable content in the narrative, so this reference must not be null.
Comments	This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).
Control	0..0
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
86. Act.text.reference.value
Comments	This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).
Control	1..1
Type	url(url: Universal Resource Locator)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
88. Act.text.reference.useablePeriod
Definition	Specifies the periods of time during which the telecommunication address can be used. For a telephone number, this can indicate the time of day in which the party can be reached on that telephone. For a web address, it may specify a time range in which the web content is promised to be available under the given address.
Control	0..*
Type	Choice of: http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
Default Type	http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
XML Format	The type of this property is determined using the " `xsi:type`attribute.
Label	Useable Period
90. Act.text.reference.use
Definition	One or more codes advising a system or user which telecommunication address in a set of like addresses to select for a given telecommunication need.
Control	0..*
Binding	The codes SHALL be taken from TelecommunicationAddressUse (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-TelecommunicationAddressUse\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Use Code
92. 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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
94. Act.statusCode
Short	Indicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
96. Act.effectiveTime
Short	The effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
Invariants	should-value-att: SHOULD contain @value (`value.exists()`)
98. Act.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
100. Act.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Comments	This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
102. Act.effectiveTime.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
104. Act.effectiveTime.low
Definition	This is the low limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
106. Act.effectiveTime.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
108. Act.effectiveTime.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
110. Act.effectiveTime.high
Definition	This is the high limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
112. Act.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
114. Act.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
116. Act.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
118. Act.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
120. Act.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
122. Act.author
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.
Short	Represents the person(s) who wrote the note.
Comments	SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
124. Act.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
126. Act.participant
Comments	MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on `Act.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
128. Act.participant:legalAuthenticator
Slice Name	legalAuthenticator
Short	Represents the person(s) legally responsible for the contents of the note.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
130. Act.participant:legalAuthenticator.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
132. Act.participant:legalAuthenticator.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
134. Act.participant:legalAuthenticator.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
136. Act.participant:legalAuthenticator.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
138. Act.participant:legalAuthenticator.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
140. Act.participant:legalAuthenticator.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
142. Act.participant:legalAuthenticator.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
144. Act.participant:legalAuthenticator.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
146. Act.participant:legalAuthenticator.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
148. Act.participant:legalAuthenticator.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`LA`
150. Act.participant:legalAuthenticator.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from CDAContextControl (required to `http://hl7.org/cda/stds/core/ValueSet/CDAContextControl`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OP`
152. Act.participant:legalAuthenticator.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`functionCode`.
154. Act.participant:legalAuthenticator.time
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Short	Indicates the time of signing the note.
Comments	SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
Is Modifier	false
Invariants	ivl-ts-center: Center cannot co-exist with low or high (`center.empty() or (low.empty() and high.empty())`) ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. (`value.exists() implies value.toString().length() >= 10`) ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. (`value.exists() implies value.toString().length() > 10`)
156. Act.participant:legalAuthenticator.awarenessCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
158. Act.participant:legalAuthenticator.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
160. Act.participant:legalAuthenticator.participantRole.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
162. Act.participant:legalAuthenticator.participantRole.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
164. Act.participant:legalAuthenticator.participantRole.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
166. Act.participant:legalAuthenticator.participantRole.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
168. Act.participant:legalAuthenticator.participantRole.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
170. Act.participant:legalAuthenticator.participantRole.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
172. Act.participant:legalAuthenticator.participantRole.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
174. Act.participant:legalAuthenticator.participantRole.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
176. Act.participant:legalAuthenticator.participantRole.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
178. Act.participant:legalAuthenticator.participantRole.classCode
Control	0..1
Binding	The codes SHALL be taken from CDARoleClassRoot (required to `http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ROL`
180. Act.participant:legalAuthenticator.participantRole.id
Short	This may be the ID of the note author. If so, no additional information in this participant is required.
Comments	This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
182. Act.participant:legalAuthenticator.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`identifiedBy`.
184. Act.participant:legalAuthenticator.participantRole.code
Control	0..1
Binding	For example codes, see CDARoleCode (example to `http://hl7.org/cda/stds/core/ValueSet/CDARoleCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
186. Act.participant:legalAuthenticator.participantRole.addr
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD
188. Act.participant:legalAuthenticator.participantRole.telecom
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
190. Act.participant:legalAuthenticator.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Device
192. Act.participant:legalAuthenticator.participantRole.playingEntity
Comments	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
194. Act.participant:legalAuthenticator.participantRole.playingEntity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
196. Act.participant:legalAuthenticator.participantRole.playingEntity.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
198. Act.participant:legalAuthenticator.participantRole.playingEntity.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
200. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
202. Act.participant:legalAuthenticator.participantRole.playingEntity.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
204. Act.participant:legalAuthenticator.participantRole.playingEntity.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
206. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
208. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
210. Act.participant:legalAuthenticator.participantRole.playingEntity.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
212. Act.participant:legalAuthenticator.participantRole.playingEntity.classCode
Control	0..1
Binding	The codes SHALL be taken from EntityClassRoot (required to `http://terminology.hl7.org/ValueSet/v3-EntityClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ENT`
214. Act.participant:legalAuthenticator.participantRole.playingEntity.determinerCode
Control	0..1
Binding	The codes SHALL be taken from EntityDeterminer (required to `http://terminology.hl7.org/ValueSet/v3-EntityDeterminer`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`INSTANCE`
216. Act.participant:legalAuthenticator.participantRole.playingEntity.code
Control	0..1
Binding	For example codes, see CDAEntityCode (example to `http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
218. Act.participant:legalAuthenticator.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
220. Act.participant:legalAuthenticator.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Short	Base for all types and resources
Comments	The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifier	false
Invariants	pn-no-ls: No PN name part may have a qualifier of LS. (`(item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).where(qualifier.where($this = 'LS').exists()).empty()`) 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (`conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()`) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (`item.xmlText.exists() implies (item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).empty()`)
222. Act.participant:legalAuthenticator.participantRole.playingEntity.sdtcBirthTime
Definition	The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`birthTime`.
224. Act.participant:legalAuthenticator.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
226. Act.participant:legalAuthenticator.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Entity
228. Act.entryRelationship
Comments	SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ encounter
230. Act.entryRelationship:encounter
Slice Name	encounter
Short	Links the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
232. Act.entryRelationship:encounter.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
234. Act.entryRelationship:encounter.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
236. Act.entryRelationship:encounter.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
238. Act.entryRelationship:encounter.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
240. Act.entryRelationship:encounter.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
242. Act.entryRelationship:encounter.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
244. Act.entryRelationship:encounter.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
246. Act.entryRelationship:encounter.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
248. Act.entryRelationship:encounter.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
250. Act.entryRelationship:encounter.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`COMP`
252. Act.entryRelationship:encounter.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.
Comments	SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).
Control	1..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`true`
254. Act.entryRelationship:encounter.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.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
256. Act.entryRelationship:encounter.negationInd
Short	To communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
Comments	MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
258. Act.entryRelationship:encounter.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
260. Act.entryRelationship:encounter.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
262. Act.entryRelationship:encounter.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
264. Act.entryRelationship:encounter.encounter
Comments	SHALL contain exactly one [1..1] encounter (CONF:3250-16908).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
266. Act.entryRelationship:encounter.encounter.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
268. Act.entryRelationship:encounter.encounter.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
270. Act.entryRelationship:encounter.encounter.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
272. Act.entryRelationship:encounter.encounter.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
274. Act.entryRelationship:encounter.encounter.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
276. Act.entryRelationship:encounter.encounter.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
278. Act.entryRelationship:encounter.encounter.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
280. Act.entryRelationship:encounter.encounter.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
282. Act.entryRelationship:encounter.encounter.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
284. Act.entryRelationship:encounter.encounter.classCode
Control	1..1
Binding	The codes SHALL be taken from CDAActClass (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClass`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ENC`
286. Act.entryRelationship:encounter.encounter.moodCode
Control	1..1
Binding	The codes SHALL be taken from XDocumentEncounterMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
288. Act.entryRelationship:encounter.encounter.id
Comments	This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
290. Act.entryRelationship:encounter.encounter.code
Control	0..1
Binding	For example codes, see ActEncounterCode (example to `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
292. Act.entryRelationship:encounter.encounter.text
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
294. Act.entryRelationship:encounter.encounter.statusCode
Control	0..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
296. Act.entryRelationship:encounter.encounter.effectiveTime
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
298. Act.entryRelationship:encounter.encounter.sdtcDischargeDispositionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`dischargeDispositionCode`.
300. Act.entryRelationship:encounter.encounter.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
302. Act.entryRelationship:encounter.encounter.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
304. Act.entryRelationship:encounter.encounter.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
306. Act.entryRelationship:encounter.encounter.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
308. Act.entryRelationship:encounter.encounter.author
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author
310. Act.entryRelationship:encounter.encounter.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
312. Act.entryRelationship:encounter.encounter.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
314. Act.entryRelationship:encounter.encounter.entryRelationship
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
316. Act.entryRelationship:encounter.encounter.reference
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
318. Act.entryRelationship:encounter.encounter.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
320. Act.entryRelationship:encounter.encounter.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
322. Act.entryRelationship:encounter.encounter.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.
324. Act.entryRelationship:encounter.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
326. Act.entryRelationship:encounter.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
328. Act.entryRelationship:encounter.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
330. Act.entryRelationship:encounter.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
332. Act.entryRelationship:encounter.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
334. Act.entryRelationship:encounter.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
336. Act.entryRelationship:encounter.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
338. Act.reference
Comments	MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
Slicing	This element introduces a set of slices on `Act.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: exists @ externalDocument
340. Act.reference:externalDocument
Slice Name	externalDocument
Short	Represents an unstructured C-CDA document containing the original contents of the note in the original format.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
342. Act.reference:externalDocument.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
344. Act.reference:externalDocument.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
346. Act.reference:externalDocument.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
348. Act.reference:externalDocument.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
350. Act.reference:externalDocument.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
352. Act.reference:externalDocument.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
354. Act.reference:externalDocument.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
356. Act.reference:externalDocument.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
358. Act.reference:externalDocument.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
360. Act.reference:externalDocument.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
362. Act.reference:externalDocument.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
364. Act.reference:externalDocument.externalAct
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
366. Act.reference:externalDocument.externalObservation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
368. Act.reference:externalDocument.externalProcedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
370. Act.reference:externalDocument.externalDocument
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
Invariants	should-code: SHOULD contain code (`code.exists()`)
372. Act.reference:externalDocument.externalDocument.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
374. Act.reference:externalDocument.externalDocument.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
376. Act.reference:externalDocument.externalDocument.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
378. Act.reference:externalDocument.externalDocument.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
380. Act.reference:externalDocument.externalDocument.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
382. Act.reference:externalDocument.externalDocument.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).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
384. Act.reference:externalDocument.externalDocument.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
386. Act.reference:externalDocument.externalDocument.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
388. Act.reference:externalDocument.externalDocument.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
390. Act.reference:externalDocument.externalDocument.classCode
Control	0..1
Binding	The codes SHALL be taken from ActClassDocument (required to `http://terminology.hl7.org/ValueSet/v3-ActClassDocument`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`DOC`
392. Act.reference:externalDocument.externalDocument.moodCode
Control	0..1
Binding	The codes SHALL be taken from CDAActMood (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActMood`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
394. Act.reference:externalDocument.externalDocument.id
Comments	This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
396. Act.reference:externalDocument.externalDocument.code
Comments	This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).
Control	0..1
Binding	For example codes, see FHIRDocumentTypeCodes (example to `http://hl7.org/fhir/ValueSet/doc-typecodes`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
398. Act.reference:externalDocument.externalDocument.text
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
400. Act.reference:externalDocument.externalDocument.setId
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
402. Act.reference:externalDocument.externalDocument.versionNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
404. Act.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
406. Act.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
408. Act.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.