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

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Logical Model: Procedure Activity Procedure

This template is used to represent the details of current and historical procedures performed on or for a patient. A procedure is an activity that is performed on, with, or for a patient as part of the provision of care. Examples include surgical procedures, diagnostic procedures, endoscopic procedures, biopsies, counseling, physiotherapy, personal support services, adult day care services, non-emergency transportation, home modification, exercise, etc. Procedures may be performed by a healthcare professional, a service provider, a friend or relative or in some cases by the patient themselves.

Usage:

• Use this Logical Model: Anesthesia Section, Intervention Act, Medical Equipment Organizer, Medical Equipment Section... Show 2 more, Procedures Section and Reaction Observation

Formal Views of Template Content

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

• Key Elements Table
• Differential Table
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• Statistics/References
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This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:procedure		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs
@moodCode		1..1	cs	Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
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
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
@nullFlavor		0..0
@code		1..1	cs	Binding: ProcedureAct statusCode (required)
effectiveTime	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year.
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
high		0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime
priorityCode		0..1	CE	Binding: ActPriority (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
performer		0..*	Performer2
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
id		1..*	II
addr		1..*	USRealmAddress	Base for all types and resources
telecom		1..*	TEL
assignedPerson		0..1	Person
name		1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr		1..*	USRealmAddress	Base for all types and resources
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@typeCode		1..1	cs	Fixed Value: DEV
participantRole		1..1	ProductInstance	Base for all types and resources
participant:serviceDeliveryLocation		0..*	Participant2	participant
@typeCode		1..1	cs	Fixed Value: LOC
participantRole		1..1	ServiceDeliveryLocation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
encounter		1..1	Encounter
@classCode		1..1	cs
@moodCode		1..1	cs	Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
entryRelationship:instruction		0..1	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act		1..1	Instruction	Base for all types and resources
encounter		0..0
entryRelationship:indication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: RSON
encounter		0..0
observation		1..1	Indication	Base for all types and resources
entryRelationship:medication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
encounter		0..0
substanceAdministration		1..1	MedicationActivity	Base for all types and resources
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
encounter		0..0
observation		1..1	ReactionObservation	Base for all types and resources
entryRelationship:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Fixed Value: RSON
encounter		0..0
observation		1..1	AssessmentScaleObservation	Base for all types and resources
entryRelationship:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Fixed Value: RSON
act		1..1	EntryReference	Base for all types and resources
encounter		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:procedure		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs	Binding: ActClassProcedure (required) Fixed Value: PROC
@moodCode		1..1	cs	Binding: x_DocumentProcedureMood (required) Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
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
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	Binding: ProcedureAct statusCode (required)
effectiveTime	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time ivl-ts-center: Center cannot co-exist with low or high ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year. Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
high	C	0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute
priorityCode		0..1	CE	Binding: ActPriority (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
performer		0..*	Performer2
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
id		1..*	II
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
telecom		1..*	TEL
assignedPerson		0..1	Person
name	C	1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372).
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: DEV
participantRole	C	1..1	ProductInstance	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
participant:serviceDeliveryLocation		0..*	Participant2	participant
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: LOC
participantRole	C	1..1	ServiceDeliveryLocation	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
encounter		1..1	Encounter
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: ENC
@moodCode		1..1	cs	Binding: XDocumentEncounterMood (2.0.0) (required) Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
entryRelationship:instruction		0..1	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:indication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
entryRelationship:medication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	AssessmentScaleObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.classCode	required	Fixed Value: PROC http://terminology.hl7.org/ValueSet/v3-ActClassProcedure
Procedure.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentProcedureMood
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
Procedure.participant:productInstance.typeCode	required	Fixed Value: DEV http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:serviceDeliveryLocation.typeCode	required	Fixed Value: LOC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.entryRelationship:encounter.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:encounter.encounter.classCode	required	Fixed Value: ENC http://hl7.org/cda/stds/core/ValueSet/CDAActClass
Procedure.entryRelationship:encounter.encounter.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0
Procedure.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:medication.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:reaction.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:assessmentScaleObs.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:entryReference.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
81-7296	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	**SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty()
81-9371	error	Procedure.performer.assignedEntity.assignedPerson.name	The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()
81-9372	error	Procedure.performer.assignedEntity.assignedPerson.name	The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))
81-10025	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Procedure.entryRelationship:medication.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	Procedure.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
ivl-ts-center	error	Procedure.effectiveTime	Center cannot co-exist with low or high : center.empty() or (low.empty() and high.empty())
ivl-value-shall	error	Procedure.effectiveTime	If a time interval contains @value, then it shall be precise to at least the day. : value.exists() implies value.toString().length() >= 10
ivl-value-should	warning	Procedure.effectiveTime	If a time interval contains @value, then it SHOULD contain a time component. : value.exists() implies value.toString().length() > 10
pn-no-ls	error	Procedure.performer.assignedEntity.assignedPerson.name	No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty()
role-choice	error	Procedure.participant:productInstance.participantRole, Procedure.participant:serviceDeliveryLocation.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
shall-city	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1
shall-max-ad-parts	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)
shall-streetAddressLine	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)
should-addr	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain addr : addr.exists()
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-author	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain author : author.exists()
should-country	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain country : nullFlavor.exists() or item.country.exists()
should-effectiveTime	warning	Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-routeCode	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-telecom	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain telecom : telecom.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Procedure.entryRelationship:instruction.act, Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:medication.substanceAdministration, Procedure.entryRelationship:reaction.observation, Procedure.entryRelationship:assessmentScaleObs.observation, Procedure.entryRelationship:entryReference.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-use	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain @use : nullFlavor.exists() or use.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-shall-day	error	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHALL** be precise to at least the day : nullFlavor.exists() or value.toString().length() >= 10
ts-should-minute	warning	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHOULD** be precise to at least the minute : nullFlavor.exists() or value.toString().length() > 10
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
@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:procedure		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: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs	Binding: ActClassProcedure (required) Fixed Value: PROC
@moodCode		1..1	cs	Binding: x_DocumentProcedureMood (required) Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		0..1	cs
@codeSystem		0..1	oid, uuid, ruid
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
@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
qualifier		0..*	CR
translation		0..*	CD
@negationInd		0..1	bl
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)
@code		1..1	cs	Binding: ProcedureAct statusCode (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	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time ivl-ts-center: Center cannot co-exist with low or high ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year. Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@inclusive		0..1	bl
center		0..1	TS
width		0..1	PQ
high	C	0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@inclusive		0..1	bl
priorityCode		0..1	CE	Binding: ActPriority (required)
languageCode		0..1	CS	Binding: AllLanguages (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
approachSiteCode		0..*	CD
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
subject		0..1	Subject
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
@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: CDAParticipationType (required) Fixed Value: SPC
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
@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
@classCode		0..1	cs	Binding: RoleClassSpecimen (required) Fixed Value: SPEC
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
sdtcIdentifiedBy		0..*	IdentifiedBy	XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc)
specimenPlayingEntity		0..1	PlayingEntity
performer		0..*	Performer2
@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: ParticipationPhysicalPerformer (required) Fixed Value: PRF
sdtcFunctionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc)
time		0..1	IVL_TS
modeCode		0..1	CE
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
@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
@classCode		0..1	cs	Binding: RoleClassAssignedEntity (required) Fixed Value: ASSIGNED
id		1..*	II
sdtcIdentifiedBy		0..*	IdentifiedBy	XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc)
code		0..1	CE	Binding: CDARoleCode (example)
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
telecom		1..*	TEL
assignedPerson		0..1	Person
@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
@classCode		0..1	cs	Binding: EntityClassLivingSubject (required) Fixed Value: PSN
@determinerCode		0..1	cs	Binding: EntityDeterminer (required) Fixed Value: INSTANCE
name	C	1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372).
sdtcDesc		0..1	ED	XML Namespace: urn:hl7-org:sdtc XML: desc (urn:hl7-org:sdtc)
sdtcAsPatientRelationship		0..*	InfrastructureRoot	XML Namespace: urn:hl7-org:sdtc XML: asPatientRelationship (urn:hl7-org:sdtc)
@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
@classCode		1..1	cs	Fixed Value: PRS
@determinerCode		0..1	cs	Fixed Value: INSTANCE
code		1..1	CE	XML Namespace: urn:hl7-org:sdtc XML Namespace: urn:hl7-org:sdtc
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
@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
@classCode		0..1	cs	Binding: EntityClassOrganization (required) Fixed Value: ORG
@determinerCode		0..1	cs	Binding: EntityDeterminer (required) Fixed Value: INSTANCE
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
standardIndustryClassCode		0..1	CE	Binding: OrganizationIndustryClassNAICS (example)
asOrganizationPartOf		0..1	OrganizationPartOf
sdtcPatient		0..1	Base	XML Namespace: urn:hl7-org:sdtc XML: patient (urn:hl7-org:sdtc)
id		1..1	II	XML Namespace: urn:hl7-org:sdtc XML Namespace: urn:hl7-org:sdtc
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@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		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: DEV
@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	C	1..1	ProductInstance	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
participant:serviceDeliveryLocation		0..*	Participant2	participant
@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		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: LOC
@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	C	1..1	ServiceDeliveryLocation	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		1..1	Encounter
@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
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: ENC
@moodCode		1..1	cs	Binding: XDocumentEncounterMood (2.0.0) (required) Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
code		0..1	CD	Binding: ActEncounterCode (example)
text		0..1	ED
statusCode		0..1	CS	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS
sdtcDischargeDispositionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: dischargeDispositionCode (urn:hl7-org:sdtc)
priorityCode		0..1	CE	Binding: ActPriority (example)
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)
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
observation		0..1	Observation
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:instruction		0..1	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
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	entryRelationship
@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		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
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
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:medication		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
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:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@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		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
observation	C	1..1	AssessmentScaleObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
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:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@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		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	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.templateId:procedure.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.classCode	required	Fixed Value: PROC http://terminology.hl7.org/ValueSet/v3-ActClassProcedure
Procedure.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentProcedureMood
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.code.originalText.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.code.originalText.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Procedure.code.originalText.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Procedure.code.originalText.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Procedure.code.originalText.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Procedure.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Procedure.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Procedure.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Procedure.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Procedure.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.effectiveTime.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.effectiveTime.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Procedure.effectiveTime.low.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.effectiveTime.high.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
Procedure.specimen.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.typeCode	required	Fixed Value: SPC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.specimen.specimenRole.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.specimenRole.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.specimenRole.classCode	required	Fixed Value: SPEC http://terminology.hl7.org/ValueSet/v3-RoleClassSpecimen
Procedure.performer.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.typeCode	required	Fixed Value: PRF http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Procedure.performer.assignedEntity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.classCode	required	Fixed Value: ASSIGNED http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Procedure.performer.assignedEntity.code	example	CDARoleCode http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Procedure.performer.assignedEntity.assignedPerson.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.classCode	required	Fixed Value: PSN http://terminology.hl7.org/ValueSet/v3-EntityClassLivingSubject
Procedure.performer.assignedEntity.assignedPerson.determinerCode	required	Fixed Value: INSTANCE http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Procedure.performer.assignedEntity.assignedPerson.sdtcAsPatientRelationship.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.sdtcAsPatientRelationship.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.classCode	required	Fixed Value: ORG http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Procedure.performer.assignedEntity.representedOrganization.determinerCode	required	Fixed Value: INSTANCE http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Procedure.performer.assignedEntity.representedOrganization.standardIndustryClassCode	example	OrganizationIndustryClassNAICS http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Procedure.participant:productInstance.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:productInstance.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:productInstance.typeCode	required	Fixed Value: DEV http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:productInstance.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Procedure.participant:serviceDeliveryLocation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:serviceDeliveryLocation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:serviceDeliveryLocation.typeCode	required	Fixed Value: LOC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:serviceDeliveryLocation.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Procedure.entryRelationship:encounter.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:encounter.encounter.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.encounter.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.encounter.classCode	required	Fixed Value: ENC http://hl7.org/cda/stds/core/ValueSet/CDAActClass
Procedure.entryRelationship:encounter.encounter.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0
Procedure.entryRelationship:encounter.encounter.code	example	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Procedure.entryRelationship:encounter.encounter.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.entryRelationship:encounter.encounter.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Procedure.entryRelationship:instruction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:indication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:indication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:medication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:medication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:medication.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:reaction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:reaction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:reaction.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:assessmentScaleObs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:assessmentScaleObs.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:assessmentScaleObs.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:entryReference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:entryReference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:entryReference.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
81-7296	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	**SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty()
81-9371	error	Procedure.performer.assignedEntity.assignedPerson.name	The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()
81-9372	error	Procedure.performer.assignedEntity.assignedPerson.name	The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))
81-10025	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Procedure.entryRelationship:medication.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	Procedure.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
ivl-ts-center	error	Procedure.effectiveTime	Center cannot co-exist with low or high : center.empty() or (low.empty() and high.empty())
ivl-value-shall	error	Procedure.effectiveTime	If a time interval contains @value, then it shall be precise to at least the day. : value.exists() implies value.toString().length() >= 10
ivl-value-should	warning	Procedure.effectiveTime	If a time interval contains @value, then it SHOULD contain a time component. : value.exists() implies value.toString().length() > 10
pn-no-ls	error	Procedure.performer.assignedEntity.assignedPerson.name	No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty()
role-choice	error	Procedure.participant:productInstance.participantRole, Procedure.participant:serviceDeliveryLocation.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
shall-city	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1
shall-max-ad-parts	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)
shall-streetAddressLine	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)
should-addr	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain addr : addr.exists()
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-author	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain author : author.exists()
should-country	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain country : nullFlavor.exists() or item.country.exists()
should-effectiveTime	warning	Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-routeCode	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-telecom	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain telecom : telecom.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Procedure.entryRelationship:instruction.act, Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:medication.substanceAdministration, Procedure.entryRelationship:reaction.observation, Procedure.entryRelationship:assessmentScaleObs.observation, Procedure.entryRelationship:entryReference.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-use	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain @use : nullFlavor.exists() or use.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-shall-day	error	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHALL** be precise to at least the day : nullFlavor.exists() or value.toString().length() >= 10
ts-should-minute	warning	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHOULD** be precise to at least the minute : nullFlavor.exists() or value.toString().length() > 10
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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 Procedure

Summary

Mandatory: 9 elements(15 nested mandatory elements)
Fixed: 13 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

• US Realm Date and Time - Interval (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmDateTimeInterval)
• US Realm Address (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmAddress)
• US Realm Person Name (PN.US.FIELDED) (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPersonNamePNUSFIELDED)
• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Product Instance (http://hl7.org/cda/us/ccda/StructureDefinition/ProductInstance)
• Service Delivery Location (http://hl7.org/cda/us/ccda/StructureDefinition/ServiceDeliveryLocation)
• Instruction (http://hl7.org/cda/us/ccda/StructureDefinition/Instruction)
• Indication (http://hl7.org/cda/us/ccda/StructureDefinition/Indication)
• Medication Activity (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity)
• Reaction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ReactionObservation)
• Assessment Scale Observation (http://hl7.org/cda/us/ccda/StructureDefinition/AssessmentScaleObservation)
• Entry Reference (http://hl7.org/cda/us/ccda/StructureDefinition/EntryReference)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Procedure.templateId
• The element 1 is sliced based on the value of Procedure.participant
• The element 4 is sliced based on the values of Procedure.entryRelationship

Differential View

This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:procedure		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs
@moodCode		1..1	cs	Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
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
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
@nullFlavor		0..0
@code		1..1	cs	Binding: ProcedureAct statusCode (required)
effectiveTime	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year.
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
high		0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime
priorityCode		0..1	CE	Binding: ActPriority (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
performer		0..*	Performer2
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
id		1..*	II
addr		1..*	USRealmAddress	Base for all types and resources
telecom		1..*	TEL
assignedPerson		0..1	Person
name		1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr		1..*	USRealmAddress	Base for all types and resources
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@typeCode		1..1	cs	Fixed Value: DEV
participantRole		1..1	ProductInstance	Base for all types and resources
participant:serviceDeliveryLocation		0..*	Participant2	participant
@typeCode		1..1	cs	Fixed Value: LOC
participantRole		1..1	ServiceDeliveryLocation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
encounter		1..1	Encounter
@classCode		1..1	cs
@moodCode		1..1	cs	Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
entryRelationship:instruction		0..1	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act		1..1	Instruction	Base for all types and resources
encounter		0..0
entryRelationship:indication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: RSON
encounter		0..0
observation		1..1	Indication	Base for all types and resources
entryRelationship:medication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
encounter		0..0
substanceAdministration		1..1	MedicationActivity	Base for all types and resources
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
encounter		0..0
observation		1..1	ReactionObservation	Base for all types and resources
entryRelationship:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Fixed Value: RSON
encounter		0..0
observation		1..1	AssessmentScaleObservation	Base for all types and resources
entryRelationship:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Fixed Value: RSON
act		1..1	EntryReference	Base for all types and resources
encounter		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:procedure		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs	Binding: ActClassProcedure (required) Fixed Value: PROC
@moodCode		1..1	cs	Binding: x_DocumentProcedureMood (required) Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
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
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	Binding: ProcedureAct statusCode (required)
effectiveTime	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time ivl-ts-center: Center cannot co-exist with low or high ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year. Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
high	C	0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute
priorityCode		0..1	CE	Binding: ActPriority (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
performer		0..*	Performer2
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
id		1..*	II
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
telecom		1..*	TEL
assignedPerson		0..1	Person
name	C	1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372).
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: DEV
participantRole	C	1..1	ProductInstance	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
participant:serviceDeliveryLocation		0..*	Participant2	participant
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: LOC
participantRole	C	1..1	ServiceDeliveryLocation	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
encounter		1..1	Encounter
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: ENC
@moodCode		1..1	cs	Binding: XDocumentEncounterMood (2.0.0) (required) Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
entryRelationship:instruction		0..1	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:indication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
entryRelationship:medication		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	AssessmentScaleObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.classCode	required	Fixed Value: PROC http://terminology.hl7.org/ValueSet/v3-ActClassProcedure
Procedure.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentProcedureMood
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
Procedure.participant:productInstance.typeCode	required	Fixed Value: DEV http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:serviceDeliveryLocation.typeCode	required	Fixed Value: LOC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.entryRelationship:encounter.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:encounter.encounter.classCode	required	Fixed Value: ENC http://hl7.org/cda/stds/core/ValueSet/CDAActClass
Procedure.entryRelationship:encounter.encounter.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0
Procedure.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:medication.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:reaction.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:assessmentScaleObs.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:entryReference.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
81-7296	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	**SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty()
81-9371	error	Procedure.performer.assignedEntity.assignedPerson.name	The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()
81-9372	error	Procedure.performer.assignedEntity.assignedPerson.name	The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))
81-10025	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Procedure.entryRelationship:medication.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	Procedure.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
ivl-ts-center	error	Procedure.effectiveTime	Center cannot co-exist with low or high : center.empty() or (low.empty() and high.empty())
ivl-value-shall	error	Procedure.effectiveTime	If a time interval contains @value, then it shall be precise to at least the day. : value.exists() implies value.toString().length() >= 10
ivl-value-should	warning	Procedure.effectiveTime	If a time interval contains @value, then it SHOULD contain a time component. : value.exists() implies value.toString().length() > 10
pn-no-ls	error	Procedure.performer.assignedEntity.assignedPerson.name	No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty()
role-choice	error	Procedure.participant:productInstance.participantRole, Procedure.participant:serviceDeliveryLocation.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
shall-city	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1
shall-max-ad-parts	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)
shall-streetAddressLine	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)
should-addr	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain addr : addr.exists()
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-author	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain author : author.exists()
should-country	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain country : nullFlavor.exists() or item.country.exists()
should-effectiveTime	warning	Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-routeCode	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-telecom	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain telecom : telecom.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Procedure.entryRelationship:instruction.act, Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:medication.substanceAdministration, Procedure.entryRelationship:reaction.observation, Procedure.entryRelationship:assessmentScaleObs.observation, Procedure.entryRelationship:entryReference.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-use	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain @use : nullFlavor.exists() or use.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-shall-day	error	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHALL** be precise to at least the day : nullFlavor.exists() or value.toString().length() >= 10
ts-should-minute	warning	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHOULD** be precise to at least the minute : nullFlavor.exists() or value.toString().length() > 10
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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
Procedure	C	1..1	Procedure	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, methodCode, approachSiteCode, targetSiteCode, 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) should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
@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:procedure		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: 2.16.840.1.113883.10.20.22.4.14
@extension		1..1	st	Required Pattern: 2024-05-01
@classCode		1..1	cs	Binding: ActClassProcedure (required) Fixed Value: PROC
@moodCode		1..1	cs	Binding: x_DocumentProcedureMood (required) Fixed Value: EVN
id		1..*	II
code	C	1..1	CD	(USCDI) SDOH Interventions Binding: US Core Procedure Codes (preferred) Additional Bindings Purpose Documentation Social Determinants of Health Procedures Preferred Binding For Social Determinant of Health Interventions should-otext-ref-value: SHOULD contain originalText/reference/@value
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		0..1	cs
@codeSystem		0..1	oid, uuid, ruid
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED	SHOULD reference the portion of narrative corresponding to this code
@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
qualifier		0..*	CR
translation		0..*	CD
@negationInd		0..1	bl
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)
@code		1..1	cs	Binding: ProcedureAct statusCode (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	C	1..1	USRealmDateTimeInterval	(USCDI) Performance Time ivl-ts-center: Center cannot co-exist with low or high ivl-value-shall: If a time interval contains @value, then it shall be precise to at least the day. ivl-value-should: If a time interval contains @value, then it SHOULD contain a time component. should-value: SHOULD contain value ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year. Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low	C	0..1	IVXB_TS	Indicates when a procedure started ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute ts-value-before-document: Time value must be equal to or before ClinicalDocument/effectiveTime
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@inclusive		0..1	bl
center		0..1	TS
width		0..1	PQ
high	C	0..1	IVXB_TS	Indicates when a procedure ended. If the statusCode='active', this must be after the ClinicalDcument/effectiveTime ts-shall-day: **SHALL** be precise to at least the day ts-should-minute: **SHOULD** be precise to at least the minute
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@inclusive		0..1	bl
priorityCode		0..1	CE	Binding: ActPriority (required)
languageCode		0..1	CS	Binding: AllLanguages (required)
methodCode		0..1	CE	MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).
approachSiteCode		0..*	CD
targetSiteCode		0..*	CD	In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. Binding: Body Site Value Set (required)
subject		0..1	Subject
specimen		0..*	Specimen	This specimen is for representing specimens obtained from a procedure (CONF:4515-16842).
@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: CDAParticipationType (required) Fixed Value: SPC
specimenRole	C	1..1	SpecimenRole	should-id: SHOULD contain id
@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
@classCode		0..1	cs	Binding: RoleClassSpecimen (required) Fixed Value: SPEC
id		0..*	II	If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).
sdtcIdentifiedBy		0..*	IdentifiedBy	XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc)
specimenPlayingEntity		0..1	PlayingEntity
performer		0..*	Performer2
@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: ParticipationPhysicalPerformer (required) Fixed Value: PRF
sdtcFunctionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc)
time		0..1	IVL_TS
modeCode		0..1	CE
assignedEntity	C	1..1	AssignedEntity	should-assignedPerson: SHOULD contain assignedPerson should-representedOrganization: SHOULD contain representedOrganization
@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
@classCode		0..1	cs	Binding: RoleClassAssignedEntity (required) Fixed Value: ASSIGNED
id		1..*	II
sdtcIdentifiedBy		0..*	IdentifiedBy	XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc)
code		0..1	CE	Binding: CDARoleCode (example)
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
telecom		1..*	TEL
assignedPerson		0..1	Person
@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
@classCode		0..1	cs	Binding: EntityClassLivingSubject (required) Fixed Value: PSN
@determinerCode		0..1	cs	Binding: EntityDeterminer (required) Fixed Value: INSTANCE
name	C	1..*	USRealmPersonNamePNUSFIELDED	Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372).
sdtcDesc		0..1	ED	XML Namespace: urn:hl7-org:sdtc XML: desc (urn:hl7-org:sdtc)
sdtcAsPatientRelationship		0..*	InfrastructureRoot	XML Namespace: urn:hl7-org:sdtc XML: asPatientRelationship (urn:hl7-org:sdtc)
@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
@classCode		1..1	cs	Fixed Value: PRS
@determinerCode		0..1	cs	Fixed Value: INSTANCE
code		1..1	CE	XML Namespace: urn:hl7-org:sdtc XML Namespace: urn:hl7-org:sdtc
representedOrganization	C	0..1	Organization	should-id: SHOULD contain id
@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
@classCode		0..1	cs	Binding: EntityClassOrganization (required) Fixed Value: ORG
@determinerCode		0..1	cs	Binding: EntityDeterminer (required) Fixed Value: INSTANCE
id		0..*	II
name		0..*	ON
telecom		1..*	TEL
addr	C	1..*	USRealmAddress	Base for all types and resources shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). should-use: SHOULD contain @use should-country: SHOULD contain country 81-7296: **SHALL NOT** have mixed content except for white space (CONF:81-7296) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country
standardIndustryClassCode		0..1	CE	Binding: OrganizationIndustryClassNAICS (example)
asOrganizationPartOf		0..1	OrganizationPartOf
sdtcPatient		0..1	Base	XML Namespace: urn:hl7-org:sdtc XML: patient (urn:hl7-org:sdtc)
id		1..1	II	XML Namespace: urn:hl7-org:sdtc XML Namespace: urn:hl7-org:sdtc
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:productInstance		0..*	Participant2	participant
@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		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: DEV
@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	C	1..1	ProductInstance	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
participant:serviceDeliveryLocation		0..*	Participant2	participant
@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		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: LOC
@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	C	1..1	ServiceDeliveryLocation	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, profile:substanceAdministration, exists:encounter
entryRelationship:encounter		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		1..1	Encounter
@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
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: ENC
@moodCode		1..1	cs	Binding: XDocumentEncounterMood (2.0.0) (required) Fixed Value: EVN
id		1..1	II	Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).
code		0..1	CD	Binding: ActEncounterCode (example)
text		0..1	ED
statusCode		0..1	CS	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS
sdtcDischargeDispositionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: dischargeDispositionCode (urn:hl7-org:sdtc)
priorityCode		0..1	CE	Binding: ActPriority (example)
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)
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
observation		0..1	Observation
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:instruction		0..1	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
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	entryRelationship
@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		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
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
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:medication		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:reaction		0..*	EntryRelationship	entryRelationship
@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		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
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:assessmentScaleObs		0..*	EntryRelationship	When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments.
@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		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
observation	C	1..1	AssessmentScaleObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
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:entryReference		0..*	EntryRelationship	When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments.
@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		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	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.templateId:procedure.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.classCode	required	Fixed Value: PROC http://terminology.hl7.org/ValueSet/v3-ActClassProcedure
Procedure.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentProcedureMood
Procedure.code	preferred	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.code.originalText.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.code.originalText.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Procedure.code.originalText.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Procedure.code.originalText.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Procedure.code.originalText.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Procedure.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Procedure.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Procedure.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Procedure.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Procedure.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.statusCode.code	required	ProcedureActStatusCode http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22 from https://vsac.nlm.nih.gov
Procedure.effectiveTime.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.effectiveTime.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
Procedure.effectiveTime.low.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.effectiveTime.high.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.priorityCode	required	ActPriority http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866 from https://vsac.nlm.nih.gov
Procedure.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Procedure.targetSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
Procedure.specimen.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.typeCode	required	Fixed Value: SPC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.specimen.specimenRole.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.specimenRole.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.specimen.specimenRole.classCode	required	Fixed Value: SPEC http://terminology.hl7.org/ValueSet/v3-RoleClassSpecimen
Procedure.performer.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.typeCode	required	Fixed Value: PRF http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer
Procedure.performer.assignedEntity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.classCode	required	Fixed Value: ASSIGNED http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity
Procedure.performer.assignedEntity.code	example	CDARoleCode http://hl7.org/cda/stds/core/ValueSet/CDARoleCode
Procedure.performer.assignedEntity.assignedPerson.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.classCode	required	Fixed Value: PSN http://terminology.hl7.org/ValueSet/v3-EntityClassLivingSubject
Procedure.performer.assignedEntity.assignedPerson.determinerCode	required	Fixed Value: INSTANCE http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Procedure.performer.assignedEntity.assignedPerson.sdtcAsPatientRelationship.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.assignedPerson.sdtcAsPatientRelationship.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.performer.assignedEntity.representedOrganization.classCode	required	Fixed Value: ORG http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization
Procedure.performer.assignedEntity.representedOrganization.determinerCode	required	Fixed Value: INSTANCE http://terminology.hl7.org/ValueSet/v3-EntityDeterminer
Procedure.performer.assignedEntity.representedOrganization.standardIndustryClassCode	example	OrganizationIndustryClassNAICS http://terminology.hl7.org/ValueSet/v3-OrganizationIndustryClassNAICS
Procedure.participant:productInstance.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:productInstance.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:productInstance.typeCode	required	Fixed Value: DEV http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:productInstance.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Procedure.participant:serviceDeliveryLocation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:serviceDeliveryLocation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.participant:serviceDeliveryLocation.typeCode	required	Fixed Value: LOC http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Procedure.participant:serviceDeliveryLocation.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Procedure.entryRelationship:encounter.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:encounter.encounter.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.encounter.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:encounter.encounter.classCode	required	Fixed Value: ENC http://hl7.org/cda/stds/core/ValueSet/CDAActClass
Procedure.entryRelationship:encounter.encounter.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0
Procedure.entryRelationship:encounter.encounter.code	example	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Procedure.entryRelationship:encounter.encounter.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Procedure.entryRelationship:encounter.encounter.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Procedure.entryRelationship:instruction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:indication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:indication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:medication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:medication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:medication.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:reaction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:reaction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:reaction.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:assessmentScaleObs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:assessmentScaleObs.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:assessmentScaleObs.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Procedure.entryRelationship:entryReference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:entryReference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Procedure.entryRelationship:entryReference.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
81-7296	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	**SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty()
81-9371	error	Procedure.performer.assignedEntity.assignedPerson.name	The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()
81-9372	error	Procedure.performer.assignedEntity.assignedPerson.name	The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))
81-10025	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))
active-high-ts-after-document	error	Procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Procedure.entryRelationship:medication.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	Procedure.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
ivl-ts-center	error	Procedure.effectiveTime	Center cannot co-exist with low or high : center.empty() or (low.empty() and high.empty())
ivl-value-shall	error	Procedure.effectiveTime	If a time interval contains @value, then it shall be precise to at least the day. : value.exists() implies value.toString().length() >= 10
ivl-value-should	warning	Procedure.effectiveTime	If a time interval contains @value, then it SHOULD contain a time component. : value.exists() implies value.toString().length() > 10
pn-no-ls	error	Procedure.performer.assignedEntity.assignedPerson.name	No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty()
role-choice	error	Procedure.participant:productInstance.participantRole, Procedure.participant:serviceDeliveryLocation.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
shall-city	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1
shall-max-ad-parts	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)
shall-streetAddressLine	error	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)
should-addr	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain addr : addr.exists()
should-assignedPerson	warning	Procedure.performer.assignedEntity	SHOULD contain assignedPerson : assignedPerson.exists()
should-author	warning	Procedure	SHOULD contain author : author.exists()
should-author	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain author : author.exists()
should-country	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain country : nullFlavor.exists() or item.country.exists()
should-effectiveTime	warning	Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-id	warning	Procedure.specimen.specimenRole, Procedure.performer.assignedEntity.representedOrganization	SHOULD contain id : id.exists()
should-otext-ref-value	warning	Procedure.code	SHOULD contain originalText/reference/@value : originalText.reference.value.exists()
should-performer	warning	Procedure	SHOULD contain performer : performer.exists()
should-representedOrganization	warning	Procedure.performer.assignedEntity	SHOULD contain representedOrganization : representedOrganization.exists()
should-routeCode	warning	Procedure.entryRelationship:medication.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-targetSiteCode	warning	Procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-telecom	warning	Procedure.participant:serviceDeliveryLocation.participantRole	SHOULD contain telecom : telecom.exists()
should-text-ref-value	warning	Procedure	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Procedure.entryRelationship:instruction.act, Procedure.entryRelationship:indication.observation, Procedure.entryRelationship:medication.substanceAdministration, Procedure.entryRelationship:reaction.observation, Procedure.entryRelationship:assessmentScaleObs.observation, Procedure.entryRelationship:entryReference.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-use	warning	Procedure.performer.assignedEntity.addr, Procedure.performer.assignedEntity.representedOrganization.addr	SHOULD contain @use : nullFlavor.exists() or use.exists()
should-value	warning	Procedure.effectiveTime	SHOULD contain value : value.exists()
ts-shall-day	error	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHALL** be precise to at least the day : nullFlavor.exists() or value.toString().length() >= 10
ts-should-minute	warning	Procedure.effectiveTime.low, Procedure.effectiveTime.high	**SHOULD** be precise to at least the minute : nullFlavor.exists() or value.toString().length() > 10
ts-value-before-document	error	Procedure.effectiveTime, Procedure.effectiveTime.low	Time value must be equal to or before ClinicalDocument/effectiveTime : value.exists() implies value <= %resource.effectiveTime.value
value-starts-octothorpe	error	Procedure.code.originalText.reference, Procedure.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 Procedure

Summary

Mandatory: 9 elements(15 nested mandatory elements)
Fixed: 13 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

• US Realm Date and Time - Interval (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmDateTimeInterval)
• US Realm Address (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmAddress)
• US Realm Person Name (PN.US.FIELDED) (http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPersonNamePNUSFIELDED)
• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Product Instance (http://hl7.org/cda/us/ccda/StructureDefinition/ProductInstance)
• Service Delivery Location (http://hl7.org/cda/us/ccda/StructureDefinition/ServiceDeliveryLocation)
• Instruction (http://hl7.org/cda/us/ccda/StructureDefinition/Instruction)
• Indication (http://hl7.org/cda/us/ccda/StructureDefinition/Indication)
• Medication Activity (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity)
• Reaction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ReactionObservation)
• Assessment Scale Observation (http://hl7.org/cda/us/ccda/StructureDefinition/AssessmentScaleObservation)
• Entry Reference (http://hl7.org/cda/us/ccda/StructureDefinition/EntryReference)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Procedure.templateId
• The element 1 is sliced based on the value of Procedure.participant
• The element 4 is sliced based on the values of Procedure.entryRelationship