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. For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Logical Model: Birth Sex Observation

This observation represents the sex of the patient at birth. It is the sex that is entered on the person’s birth certificate at time of birth.

This observation is not appropriate for recording patient gender (administrativeGender).

This observation is not appropriate for recording Gender Identity (GI).

It is recommended systems include the Birth Sex observation in the Social History section.

Usage:

• This Logical Model is not used by any profiles in this Implementation Guide

Formal Views of Template Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
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
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:birth-sex-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.200
@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	Sex assigned at birth
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@value		0..1	ts	value should be used instead of low/high
value		1..1	CD	Binding: Birth Sex (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
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
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:birth-sex-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.200
@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	Sex assigned at birth Binding: ObservationType (example)
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@value		0..1	ts	value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
value		1..1	CD	Binding: Birth Sex (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
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
@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:birth-sex-obs		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: 2.16.840.1.113883.10.20.22.4.200
@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		0..*	II
code		1..1	CD	Sex assigned at birth Binding: ObservationType (example)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
@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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_TS
center		0..1	TS
width		0..1	PQ
high		0..1	IVXB_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
value		1..1	CD	Binding: Birth Sex (required)
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:birth-sex-obs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.effectiveTime.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.effectiveTime.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If 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
Fixed: 3 elements

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Observation.templateId

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
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
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:birth-sex-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.200
@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	Sex assigned at birth
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@value		0..1	ts	value should be used instead of low/high
value		1..1	CD	Binding: Birth Sex (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
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
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:birth-sex-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.200
@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	Sex assigned at birth Binding: ObservationType (example)
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@value		0..1	ts	value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
value		1..1	CD	Binding: Birth Sex (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
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
@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:birth-sex-obs		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: 2.16.840.1.113883.10.20.22.4.200
@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		0..*	II
code		1..1	CD	Sex assigned at birth Binding: ObservationType (example)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Required Pattern: 76689-9
@codeSystem		1..1	oid, uuid, ruid	LOINC Required Pattern: 2.16.840.1.113883.6.1
@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	C	1..1	IVL_TS	Note: This template represents a "snapshot in time" observation, simply reflecting the patient's sex at the time of the observation. As a result, the effectiveTime is constrained to just a time stamp. Since this represents Birth Sex it SHALL match the birthTime. value-only: Interval fields SHALL not be present
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_TS
center		0..1	TS
width		0..1	PQ
high		0..1	IVXB_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
value		1..1	CD	Binding: Birth Sex (required)
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:birth-sex-obs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.effectiveTime.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.effectiveTime.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value	required	BirthSex http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.24 from https://vsac.nlm.nih.gov
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-only	error	Observation.effectiveTime	Interval fields SHALL not be present : (low | high | width | center).empty()
value-starts-octothorpe	error	Observation.text.reference	If 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
Fixed: 3 elements

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Observation.templateId

Other representations of profile: CSV, Excel