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

Logical Model: External Document Reference

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference Version: 4.0.0
Draft as of 2025-06-20 Computable Name: ExternalDocumentReference
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09

Where it is necessary to reference an external clinical document, the External Document Reference template can be used to reference this external document. However, if the containing document is appending to or replacing another document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.

Usages:

Changes since version 3.0.0:

  • No changes

    • Formal Views of Template Content

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

    This structure is derived from ExternalDocument

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:external-doc-ref 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs
    ... code 1..1 CD
    ... setId 0..1 II
    ... versionNumber 0..1 INT

    doco Documentation for this format

    Constraints

    IdGradePath(s)DetailsRequirements
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... @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:external-doc-ref 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: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Binding: ActClassDocument (required)
    Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 1..1 II
    ... code 1..1 CD Binding: FHIRDocumentTypeCodes (example)
    ... text 0..1 ED
    ... setId 0..1 II
    ... versionNumber 0..1 INT
    ... sdtcAuthor 0..* Author XML Namespace: urn:hl7-org:sdtc
    XML: author (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    ExternalDocument.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.templateId:external-doc-ref.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.classCoderequiredFixed Value: DOCCLIN
    http://terminology.hl7.org/ValueSet/v3-ActClassDocument
    ExternalDocument.moodCoderequiredFixed Value: EVN
    http://hl7.org/cda/stds/core/ValueSet/CDAActMood
    ExternalDocument.codeexampleFHIRDocumentTypeCodes
    http://hl7.org/fhir/ValueSet/doc-typecodes
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorExternalDocument.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... @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:external-doc-ref 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: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Binding: ActClassDocument (required)
    Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 1..1 II
    ... code 1..1 CD Binding: FHIRDocumentTypeCodes (example)
    ... text 0..1 ED
    ... setId 0..1 II
    ... versionNumber 0..1 INT
    ... sdtcAuthor 0..* Author XML Namespace: urn:hl7-org:sdtc
    XML: author (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    ExternalDocument.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.templateId:external-doc-ref.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.classCoderequiredFixed Value: DOCCLIN
    http://terminology.hl7.org/ValueSet/v3-ActClassDocument
    ExternalDocument.moodCoderequiredFixed Value: EVN
    http://hl7.org/cda/stds/core/ValueSet/CDAActMood
    ExternalDocument.codeexampleFHIRDocumentTypeCodes
    http://hl7.org/fhir/ValueSet/doc-typecodes
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorExternalDocument.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()

    This structure is derived from ExternalDocument

    Summary

    Mandatory: 8 elements
    Fixed: 1 element

    Slices

    This structure defines the following Slices:

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

    Differential View

    This structure is derived from ExternalDocument

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:external-doc-ref 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs
    ... code 1..1 CD
    ... setId 0..1 II
    ... versionNumber 0..1 INT

    doco Documentation for this format

    Constraints

    IdGradePath(s)DetailsRequirements
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... @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:external-doc-ref 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: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Binding: ActClassDocument (required)
    Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 1..1 II
    ... code 1..1 CD Binding: FHIRDocumentTypeCodes (example)
    ... text 0..1 ED
    ... setId 0..1 II
    ... versionNumber 0..1 INT
    ... sdtcAuthor 0..* Author XML Namespace: urn:hl7-org:sdtc
    XML: author (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    ExternalDocument.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.templateId:external-doc-ref.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.classCoderequiredFixed Value: DOCCLIN
    http://terminology.hl7.org/ValueSet/v3-ActClassDocument
    ExternalDocument.moodCoderequiredFixed Value: EVN
    http://hl7.org/cda/stds/core/ValueSet/CDAActMood
    ExternalDocument.codeexampleFHIRDocumentTypeCodes
    http://hl7.org/fhir/ValueSet/doc-typecodes
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorExternalDocument.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. ExternalDocument C 1..1 ExternalDocument XML Namespace: urn:hl7-org:v3
    Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-setId, should-versionNumber
    ... @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:external-doc-ref 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: 2.16.840.1.113883.10.20.22.4.115
    ..... @extension 1..1 st Required Pattern: 2014-06-09
    ... @classCode 1..1 cs Binding: ActClassDocument (required)
    Fixed Value: DOCCLIN
    ... @moodCode 1..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 1..1 II
    ... code 1..1 CD Binding: FHIRDocumentTypeCodes (example)
    ... text 0..1 ED
    ... setId 0..1 II
    ... versionNumber 0..1 INT
    ... sdtcAuthor 0..* Author XML Namespace: urn:hl7-org:sdtc
    XML: author (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    ExternalDocument.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.typeId.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.templateId:external-doc-ref.nullFlavorrequiredCDANullFlavor
    http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
    ExternalDocument.classCoderequiredFixed Value: DOCCLIN
    http://terminology.hl7.org/ValueSet/v3-ActClassDocument
    ExternalDocument.moodCoderequiredFixed Value: EVN
    http://hl7.org/cda/stds/core/ValueSet/CDAActMood
    ExternalDocument.codeexampleFHIRDocumentTypeCodes
    http://hl7.org/fhir/ValueSet/doc-typecodes
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    II-1errorExternalDocument.typeIdAn II instance must have either a root or an nullFlavor.
    : root.exists() or nullFlavor.exists()
    should-setIdwarningExternalDocumentSHOULD contain setId
    : setId.exists()
    should-versionNumberwarningExternalDocumentSHOULD contain versionNumber
    : versionNumber.exists()

    This structure is derived from ExternalDocument

    Summary

    Mandatory: 8 elements
    Fixed: 1 element

    Slices

    This structure defines the following Slices:

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

     

    Other representations of profile: CSV, Excel