Consolidated CDA (C-CDA)
4.0.0 - STU4 United States of America flag

This page is part of the CCDA: Consolidated CDA Release (v4.0.0: CCDA 4.0) 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: Referral Act

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ReferralAct Version: 4.0.0
Draft as of 2025-06-20 Computable Name: ReferralAct
Other Identifiers: OID:2.16.840.1.113883.10.20.22.4.140

This template represents the type of referral (e.g., for dental care, to a specialist, for aging problems) and represents whether the referral is for full care or shared care. It may contain a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).

Templates Used

Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:

Optional EntryRelationships: Indication

Usages:

Changes since version 3.0.0:

  • New Content

    • Formal Views of Template Content

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

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    .... templateId:referral-act 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
    ..... @extension 0..0
    ... @classCode 1..1 cs Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... code 1..1 CD Binding: Referral Types . (required)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @nullFlavor 0..0
    .... @code 1..1 cs Binding: ActStatus (required)
    ... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE
    ... author 0..* AuthorParticipation
    ... participant 0..* Participant2
    .... @typeCode 1..1 cs
    .... participantRole 1..1 ParticipantRole
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @typeCode 1..1 cs Fixed Value: SUBJ
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @classCode 1..1 cs Fixed Value: OBS
    ...... @moodCode 1..1 cs Fixed Value: RQO
    ...... code 1..1 CD
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ...... statusCode 1..1 CS
    ....... @code 1..1 cs Fixed Value: completed
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: RSON
    ..... observation 1..1 Indication

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61

    Constraints

    IdGradePath(s)DetailsRequirements
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:referral-act 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: 2.16.840.1.113883.10.20.22.4.140
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... @negationInd 0..1 bl
    ... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
    ... code 1..1 CD Binding: Referral Types . (required)
    ... 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 Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ActStatus (required)
    .... @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 The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author 0..* AuthorParticipation
    ... informant 0..* Informant
    ... participant 0..* Participant2
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 1..1 cs Binding: CDAParticipationType (required)
    .... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    .... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    .... time 0..1 IVL_TS
    .... awarenessCode 0..1 CE
    .... participantRole 1..1 ParticipantRole
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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
    ..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ..... id 0..* II
    ..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ..... addr 0..* AD
    ..... telecom 0..* TEL
    ..... playingDevice 0..1 Device
    ..... playingEntity 0..1 PlayingEntity
    ..... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: RQO
    ...... @negationInd 0..1 bl
    ...... id 0..* II
    ...... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ...... code 1..1 CD Binding: ObservationType (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ....... @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
    ...... 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 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... repeatNumber 0..1 IVL_INT
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    ...... 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 C 0..1 II Constraints: II-1
    ........ @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)
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: RSON
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 Indication
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:referral-act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: PCPR
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.participant.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeCoderequiredCDAParticipationType
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:careModel.observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Act.entryRelationship:careModel.observation.moodCoderequiredFixed Value: RQO
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Act.entryRelationship:careModel.observation.codeexampleObservationType
    http://terminology.hl7.org/ValueSet/v3-ObservationType
    Act.entryRelationship:careModel.observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:careModel.observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
    Act.entryRelationship:careModel.observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Act.entryRelationship:careModel.observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Act.entryRelationship:careModel.observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
    Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorAct.typeId, Act.participant.typeId, Act.participant.participantRole.typeId, Act.entryRelationship:careModel.typeId, Act.entryRelationship:careModel.observation.typeId, Act.entryRelationship:careModel.observation.referenceRange.typeId, Act.entryRelationship:indication.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:referral-act 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: 2.16.840.1.113883.10.20.22.4.140
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... @negationInd 0..1 bl
    ... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
    ... code 1..1 CD Binding: Referral Types . (required)
    ... 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 Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ActStatus (required)
    .... @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 The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author 0..* AuthorParticipation
    ... informant 0..* Informant
    ... participant 0..* Participant2
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 1..1 cs Binding: CDAParticipationType (required)
    .... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    .... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    .... time 0..1 IVL_TS
    .... awarenessCode 0..1 CE
    .... participantRole 1..1 ParticipantRole
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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
    ..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ..... id 0..* II
    ..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ..... addr 0..* AD
    ..... telecom 0..* TEL
    ..... playingDevice 0..1 Device
    ..... playingEntity 0..1 PlayingEntity
    ..... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: RQO
    ...... @negationInd 0..1 bl
    ...... id 0..* II
    ...... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ...... code 1..1 CD Binding: ObservationType (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ....... @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
    ...... 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 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... repeatNumber 0..1 IVL_INT
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    ...... 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 C 0..1 II Constraints: II-1
    ........ @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)
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: RSON
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 Indication
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:referral-act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: PCPR
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.participant.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeCoderequiredCDAParticipationType
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:careModel.observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Act.entryRelationship:careModel.observation.moodCoderequiredFixed Value: RQO
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Act.entryRelationship:careModel.observation.codeexampleObservationType
    http://terminology.hl7.org/ValueSet/v3-ObservationType
    Act.entryRelationship:careModel.observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:careModel.observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
    Act.entryRelationship:careModel.observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Act.entryRelationship:careModel.observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Act.entryRelationship:careModel.observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
    Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorAct.typeId, Act.participant.typeId, Act.participant.participantRole.typeId, Act.entryRelationship:careModel.typeId, Act.entryRelationship:careModel.observation.typeId, Act.entryRelationship:careModel.observation.referenceRange.typeId, Act.entryRelationship:indication.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 Act

    Summary

    Mandatory: 7 elements(7 nested mandatory elements)
    Fixed: 6 elements
    Prohibited: 2 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Act.templateId
    • The element 1 is sliced based on the value of Act.entryRelationship

    Differential View

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root
    .... templateId:referral-act 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
    ..... @extension 0..0
    ... @classCode 1..1 cs Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... code 1..1 CD Binding: Referral Types . (required)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @nullFlavor 0..0
    .... @code 1..1 cs Binding: ActStatus (required)
    ... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE
    ... author 0..* AuthorParticipation
    ... participant 0..* Participant2
    .... @typeCode 1..1 cs
    .... participantRole 1..1 ParticipantRole
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @typeCode 1..1 cs Fixed Value: SUBJ
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @classCode 1..1 cs Fixed Value: OBS
    ...... @moodCode 1..1 cs Fixed Value: RQO
    ...... code 1..1 CD
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ...... statusCode 1..1 CS
    ....... @code 1..1 cs Fixed Value: completed
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: RSON
    ..... observation 1..1 Indication

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61

    Constraints

    IdGradePath(s)DetailsRequirements
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:referral-act 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: 2.16.840.1.113883.10.20.22.4.140
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... @negationInd 0..1 bl
    ... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
    ... code 1..1 CD Binding: Referral Types . (required)
    ... 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 Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ActStatus (required)
    .... @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 The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author 0..* AuthorParticipation
    ... informant 0..* Informant
    ... participant 0..* Participant2
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 1..1 cs Binding: CDAParticipationType (required)
    .... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    .... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    .... time 0..1 IVL_TS
    .... awarenessCode 0..1 CE
    .... participantRole 1..1 ParticipantRole
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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
    ..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ..... id 0..* II
    ..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ..... addr 0..* AD
    ..... telecom 0..* TEL
    ..... playingDevice 0..1 Device
    ..... playingEntity 0..1 PlayingEntity
    ..... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: RQO
    ...... @negationInd 0..1 bl
    ...... id 0..* II
    ...... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ...... code 1..1 CD Binding: ObservationType (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ....... @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
    ...... 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 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... repeatNumber 0..1 IVL_INT
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    ...... 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 C 0..1 II Constraints: II-1
    ........ @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)
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: RSON
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 Indication
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:referral-act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: PCPR
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.participant.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeCoderequiredCDAParticipationType
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:careModel.observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Act.entryRelationship:careModel.observation.moodCoderequiredFixed Value: RQO
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Act.entryRelationship:careModel.observation.codeexampleObservationType
    http://terminology.hl7.org/ValueSet/v3-ObservationType
    Act.entryRelationship:careModel.observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:careModel.observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
    Act.entryRelationship:careModel.observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Act.entryRelationship:careModel.observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Act.entryRelationship:careModel.observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
    Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorAct.typeId, Act.participant.typeId, Act.participant.participantRole.typeId, Act.entryRelationship:careModel.typeId, Act.entryRelationship:careModel.observation.typeId, Act.entryRelationship:careModel.observation.referenceRange.typeId, Act.entryRelationship:indication.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, should-priorityCode, should-author
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:referral-act 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: 2.16.840.1.113883.10.20.22.4.140
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: PCPR
    ... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
    ... @negationInd 0..1 bl
    ... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
    ... code 1..1 CD Binding: Referral Types . (required)
    ... 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 Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ActStatus (required)
    .... @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 The effectiveTime represents the time when the future referral is intended to take place.
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author 0..* AuthorParticipation
    ... informant 0..* Informant
    ... participant 0..* Participant2
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @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 1..1 cs Binding: CDAParticipationType (required)
    .... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    .... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    .... time 0..1 IVL_TS
    .... awarenessCode 0..1 CE
    .... participantRole 1..1 ParticipantRole
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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
    ..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ..... id 0..* II
    ..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
    ..... addr 0..* AD
    ..... telecom 0..* TEL
    ..... playingDevice 0..1 Device
    ..... playingEntity 0..1 PlayingEntity
    ..... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Slice: Unordered, Open by profile:observation
    .... entryRelationship:careModel 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation C 1..1 Observation Constraints: should-priorityCode
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
    Fixed Value: OBS
    ...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
    Fixed Value: RQO
    ...... @negationInd 0..1 bl
    ...... id 0..* II
    ...... sdtcCategory 0..* CD XML Namespace: urn:hl7-org:sdtc
    XML: category (urn:hl7-org:sdtc)
    ...... code 1..1 CD Binding: ObservationType (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: ASSERTION
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
    ....... @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
    ...... 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 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (preferred)
    ...... repeatNumber 0..1 IVL_INT
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... value 1..1 CD Binding: Care Model . (preferred)
    ...... 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 C 0..1 II Constraints: II-1
    ........ @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)
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:indication 0..* EntryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: RSON
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 Indication
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.templateId:referral-act.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.classCoderequiredFixed Value: PCPR
    http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
    Act.moodCoderequiredPatientReferralActMoodCode .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
    Act.coderequiredReferralTypes .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
    Act.text.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.text.compressionrequiredCDACompressionAlgorithm
    http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
    Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
    http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
    Act.text.mediaTypeexampleMediaType
    http://terminology.hl7.org/ValueSet/v3-MediaType
    Act.text.representationrequiredBinaryDataEncoding
    http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
    Act.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.statusCode.coderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.priorityCodeexampleActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.participant.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.typeCoderequiredCDAParticipationType
    http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
    Act.participant.contextControlCoderequiredFixed Value: OP
    http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
    Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.participant.participantRole.classCoderequiredCDARoleClassRoot
    http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
    Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy .(a valid code from http://nucc.org/provider-taxonomy)
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
    Act.entryRelationship:careModel.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.typeCoderequiredFixed Value: SUBJ
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
    Act.entryRelationship:careModel.observation.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.classCoderequiredFixed Value: OBS
    http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
    Act.entryRelationship:careModel.observation.moodCoderequiredFixed Value: RQO
    http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
    Act.entryRelationship:careModel.observation.codeexampleObservationType
    http://terminology.hl7.org/ValueSet/v3-ObservationType
    Act.entryRelationship:careModel.observation.code.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.statusCoderequiredActStatus
    http://terminology.hl7.org/ValueSet/v3-ActStatus
    Act.entryRelationship:careModel.observation.statusCode.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.priorityCodepreferredActPriority
    http://terminology.hl7.org/ValueSet/v3-ActPriority
    Act.entryRelationship:careModel.observation.languageCoderequiredAllLanguages
    http://hl7.org/fhir/ValueSet/all-languages
    From the FHIR Standard
    Act.entryRelationship:careModel.observation.valuepreferredCareModel .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
    Act.entryRelationship:careModel.observation.interpretationCoderequiredCDAObservationInterpretation
    http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
    Act.entryRelationship:careModel.observation.methodCodeexampleObservationMethod
    http://terminology.hl7.org/ValueSet/v3-ObservationMethod
    Act.entryRelationship:careModel.observation.referenceRange.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:careModel.observation.referenceRange.typeCoderequiredFixed Value: REFV
    http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
    Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
    http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorAct.typeId, Act.participant.typeId, Act.participant.participantRole.typeId, Act.entryRelationship:careModel.typeId, Act.entryRelationship:careModel.observation.typeId, Act.entryRelationship:careModel.observation.referenceRange.typeId, Act.entryRelationship:indication.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-authorwarningActSHOULD contain author
    : author.exists()
    should-priorityCodewarningAct, Act.entryRelationship:careModel.observationSHOULD contain priorityCode
    : priorityCode.exists()
    should-text-ref-valuewarningActSHOULD contain text/reference/@value
    : text.reference.value.exists()
    value-starts-octothorpeerrorAct.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 Act

    Summary

    Mandatory: 7 elements(7 nested mandatory elements)
    Fixed: 6 elements
    Prohibited: 2 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Act.templateId
    • The element 1 is sliced based on the value of Act.entryRelationship

     

    Other representations of profile: CSV, Excel