Consolidated CDA (C-CDA)
3.0.0 - STU3 United States of America flag

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: Smoking Status

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/SmokingStatus Version: 3.0.0
Draft as of 2024-05-18 Computable Name: SmokingStatus
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.511:2024-05-01

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

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

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

Usage:

Formal Views of Template Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Fixed Value: OBS
... @moodCode 1..1 cs Fixed Value: EVN
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @code 1..1 cs
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1 CS
.... @code 1..1 cs Fixed Value: completed
... effectiveTime 1..1 IVL_TS
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive


doco Documentation for this format

Terminology Bindings (Differential)

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

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @code 1..1 cs
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1 CS Binding: ActStatus (required)
.... @code 1..1 cs Fixed Value: completed
... effectiveTime 1..1 IVL_TS
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.coderequiredSmokingStatusType .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
Observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value:coded.coderequiredSmokingStatusComprehensive .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId 0..1 II
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... @negationInd 0..1 bl
... id 1..* II
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... derivationExpr 0..1 ST
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... @operator 0..1 cs Binding: CDASetOperator (required)
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... center 0..1 TS
.... width 0..1 PQ
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... priorityCode 0..1 CE Binding: ActPriority (example)
... repeatNumber 0..1 IVL_INT
... languageCode 0..1 CS Binding: AllLanguages (required)
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive

..... @codeSystem 0..1 oid, uuid, ruid
..... @codeSystemName 0..1 st
..... @codeSystemVersion 0..1 st
..... @displayName 0..1 st
..... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
..... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
..... originalText 0..1 ED
..... qualifier 0..* CR
..... translation 0..* CD
... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
... methodCode 0..* CE Binding: ObservationMethod (example)
... targetSiteCode 0..* CD
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... entryRelationship 0..* EntryRelationship
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... referenceRange 0..* InfrastructureRoot
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... realmCode 0..* CS
.... typeId 0..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1 st
.... templateId 0..* II
.... @typeCode 0..1 cs Binding: CDAActRelationshipType (required)
Fixed Value: REFV
.... observationRange 1..1 ObservationRange
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

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

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

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

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Fixed Value: OBS
... @moodCode 1..1 cs Fixed Value: EVN
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @code 1..1 cs
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1 CS
.... @code 1..1 cs Fixed Value: completed
... effectiveTime 1..1 IVL_TS
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive


doco Documentation for this format

Terminology Bindings (Differential)

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

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @code 1..1 cs
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1 CS Binding: ActStatus (required)
.... @code 1..1 cs Fixed Value: completed
... effectiveTime 1..1 IVL_TS
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCoderequiredFixed Value: EVN
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.coderequiredSmokingStatusType .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6
Observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value:coded.coderequiredSmokingStatusComprehensive .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 1..1 Observation XML Namespace: urn:hl7-org:v3
Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
... realmCode 0..* CS
... typeId 0..1 II
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1 st
.... @displayable 0..1 bl
.... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:tobacco-use 1..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.511
..... @extension 1..1 st Required Pattern: 2024-05-01
... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... @negationInd 0..1 bl
... id 1..* II
... code 1..1 CD Binding: Smoking Status Type . (required): Smoking status type

.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs
.... @codeSystem 0..1 oid, uuid, ruid
.... @codeSystemName 0..1 st
.... @codeSystemVersion 0..1 st
.... @displayName 0..1 st
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... derivationExpr 0..1 ST
... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
.... @integrityCheck 0..1 bin
.... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs
.... @mediaType 0..1 cs Binding: MediaType (example)
.... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
.... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1 ED
... statusCode 1..1 CS Binding: ActStatus (required)
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @code 1..1 cs Fixed Value: completed
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... @value 0..1 ts Represents a timestamp indicating a "point in time" when the observation was true
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... @operator 0..1 cs Binding: CDASetOperator (required)
.... low 0..1 IVXB_TS Represents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
.... center 0..1 TS
.... width 0..1 PQ
.... high 0..1 IVXB_TS Represents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
... priorityCode 0..1 CE Binding: ActPriority (example)
... repeatNumber 0..1 IVL_INT
... languageCode 0..1 CS Binding: AllLanguages (required)
... Slices for value 1..1 REAL shall only be used for Smoking Status where code = 401201003 or 782516008
Slice: Unordered, Closed by type:$this
.... value CD
.... value REAL
.... value:packYears 0..1 REAL Only used for Smoking Status where code = 401201003 or 782516008
.... value:coded 0..1 CD
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @code 1..1 cs Binding: Smoking status comprehensive . (required): Smoking status comprehensive

..... @codeSystem 0..1 oid, uuid, ruid
..... @codeSystemName 0..1 st
..... @codeSystemVersion 0..1 st
..... @displayName 0..1 st
..... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
..... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
..... originalText 0..1 ED
..... qualifier 0..* CR
..... translation 0..* CD
... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
... methodCode 0..* CE Binding: ObservationMethod (example)
... targetSiteCode 0..* CD
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... entryRelationship 0..* EntryRelationship
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... referenceRange 0..* InfrastructureRoot
.... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
.... realmCode 0..* CS
.... typeId 0..1 II
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1 st
..... @displayable 0..1 bl
..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1 st
.... templateId 0..* II
.... @typeCode 0..1 cs Binding: CDAActRelationshipType (required)
Fixed Value: REFV
.... observationRange 1..1 ObservationRange
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

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

Constraints

IdGradePath(s)DetailsRequirements
coded-valueerrorObservationWhen code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded
: (code.code = '72166-2' or code.code = '11367-0') implies value.code.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

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

Slices

This structure defines the following Slices:

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

 

Other representations of profile: CSV, Excel