Consolidated CDA Release 2.1 StructureDefinition Publication
2.1 - CI Build United States of America flag

Consolidated CDA Release 2.1 StructureDefinition Publication, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.1). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.1-sd/ and changes regularly. See the Directory of published versions

Logical Model: NoteActivity - Detailed Descriptions

Draft as of 2023-09-29

Definitions for the NoteActivity logical model.

Guidance on how to interpret the contents of this table can be found here

0. Act
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
2. Act.classCode
Comments

SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

Fixed ValueACT
4. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

Fixed ValueEVN
6. Act.templateId
Comments

SHALL contain exactly one [1..1] templateId (CONF:3250-16933) such that it

Control1..?
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
8. Act.templateId:templateId1
Slice NametemplateId1
ShorttemplateId
Control1..1
10. Act.templateId:templateId1.root
Comments

SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.202" (CONF:3250-16934).

Control1..?
Pattern Value2.16.840.1.113883.10.20.22.4.202
12. Act.templateId:templateId1.extension
Comments

SHALL contain exactly one [1..1] @extension="2016-11-01" (CONF:3250-16937).

Control1..?
Pattern Value2016-11-01
14. Act.code
Comments

SHALL contain exactly one [1..1] code (CONF:3250-16895).

16. Act.code.code
Comments

This code SHALL contain exactly one [1..1] @code="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).

Control1..?
Pattern Value34109-9
18. Act.code.codeSystem
Comments

This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" LOINC (CONF:3250-16941).

Control1..?
Pattern Value2.16.840.1.113883.6.1
20. Act.code.translation
Comments

This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).

BindingThe codes SHOULD be taken from Note Types
Invariants3250-16942: If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942). ()
3250-16943: If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). ()
22. Act.text
Comments

SHALL contain exactly one [1..1] text (CONF:3250-16896).

Control1..?
24. Act.text.mediaType
Comments

This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

BindingThe codes SHOULD be taken from SupportedFileFormats
Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). ()
26. Act.text.reference
Comments

This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

Control1..?
28. Act.text.reference.nullFlavor
Comments

This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

Control0..0
30. Act.text.reference.value
Comments

This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

Control1..?
Invariants3250-16902: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:3250-16902). ()
32. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

Control1..?
34. Act.effectiveTime
Comments

SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

Control1..?
36. Act.effectiveTime.value
Comments

This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

38. Act.author
Comments

SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
40. Act.participant
Comments

MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

SlicingThis element introduces a set of slices on Act.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ participantRole
  • value @ typeCode
42. Act.participant:participant1
Slice Nameparticipant1
Shortparticipant
Control0..*
44. Act.participant:participant1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

Control1..?
Fixed ValueLA
46. Act.participant:participant1.time
Comments

SHALL contain exactly one [1..1] US Realm Date and Time (DT.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time (DT.US.FIELDED))
48. Act.participant:participant1.participantRole
Comments

SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
50. Act.participant:participant1.participantRole.id
Comments

This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

Control1..?
52. Act.participant:participant1.participantRole.playingEntity
Comments

This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

54. Act.participant:participant1.participantRole.playingEntity.name
Comments

The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
56. Act.entryRelationship
Comments

SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ encounter
  • value @ typeCode
  • value @ inversionInd
58. Act.entryRelationship:entryRelationship1
Slice NameentryRelationship1
ShortentryRelationship
Control0..*
60. Act.entryRelationship:entryRelationship1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

Fixed ValueCOMP
62. Act.entryRelationship:entryRelationship1.inversionInd
Comments

SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

Control1..?
Fixed Valuetrue
64. Act.entryRelationship:entryRelationship1.negationInd
Comments

MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

66. Act.entryRelationship:entryRelationship1.encounter
Comments

SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

Control1..?
68. Act.entryRelationship:entryRelationship1.encounter.id
Comments

This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).

Control1..?
Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
70. Act.reference
Comments

MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

SlicingThis element introduces a set of slices on Act.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ externalDocument
72. Act.reference:reference1
Slice Namereference1
Shortreference
Control0..*
74. Act.reference:reference1.externalDocument
Comments

SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

Control1..?
76. Act.reference:reference1.externalDocument.id
Comments

This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

Control1..1
78. Act.reference:reference1.externalDocument.code
Comments

This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

Guidance on how to interpret the contents of this table can be found here

0. Act
Definition

Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Act.classCode
Definition

Element Act.classCode

Comments

SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueACT
4. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueEVN
6. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Comments

SHALL contain exactly one [1..1] templateId (CONF:3250-16933) such that it

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
8. Act.templateId:templateId1
Slice NametemplateId1
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

ShorttemplateId
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
10. Act.templateId:templateId1.root
Definition

A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

Comments

SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.202" (CONF:3250-16934).

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Pattern Value2.16.840.1.113883.10.20.22.4.202
12. Act.templateId:templateId1.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Comments

SHALL contain exactly one [1..1] @extension="2016-11-01" (CONF:3250-16937).

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
Pattern Value2016-11-01
14. Act.code
Comments

SHALL contain exactly one [1..1] code (CONF:3250-16895).

Control1..1
BindingUnless not suitable, these codes SHALL be taken from v3 Code System ActCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
16. Act.code.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Comments

This code SHALL contain exactly one [1..1] @code="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
Pattern Value34109-9
18. Act.code.codeSystem
Definition

Specifies the code system that defines the code.

Comments

This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" LOINC (CONF:3250-16941).

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
Pattern Value2.16.840.1.113883.6.1
20. Act.code.translation
Definition

A set of other concept descriptors that translate this concept descriptor into other code systems.

Comments

This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).

Control0..*
BindingThe codes SHOULD be taken from Note Types
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelTranslation
Invariants3250-16942: If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942). ()
3250-16943: If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). ()
22. Act.text
Comments

SHALL contain exactly one [1..1] text (CONF:3250-16896).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
24. Act.text.mediaType
Definition

Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

Comments

This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

Control0..1
BindingThe codes SHOULD be taken from SupportedFileFormats
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelMedia Type
Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). ()
26. Act.text.reference
Definition

A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

Comments

This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
LabelReference
28. Act.text.reference.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Comments

This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

Control0..0
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
30. Act.text.reference.value
Comments

This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

Control1..1
Typeurl(url: Universal Resource Locator)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Invariants3250-16902: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:3250-16902). ()
32. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

Control1..1
BindingThe codes SHALL be taken from ActStatus
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
34. Act.effectiveTime
Comments

SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
36. Act.effectiveTime.value
Definition

A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

Comments

This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

Control0..1
Typestring(ts: Point in Time)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
XML FormatIn the XML format, this property is represented as an attribute.
38. Act.author
Definition

Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Comments

SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Act.participant
Comments

MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
SlicingThis element introduces a set of slices on Act.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ participantRole
  • value @ typeCode
42. Act.participant:participant1
Slice Nameparticipant1
Shortparticipant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
44. Act.participant:participant1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

Control1..1
BindingThe codes SHALL be taken from ParticipationType
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueLA
46. Act.participant:participant1.time
Definition

A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] US Realm Date and Time (DT.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time (DT.US.FIELDED))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ivl-ts-center: Center cannot co-exist with low or high (center.empty() or (low.empty() and high.empty()))
81-10078: **SHALL** be precise to the day (CONF:81-10078). ()
81-10079: **SHOULD** be precise to the minute (CONF:81-10079). ()
81-10080: **MAY** be precise to the second (CONF:81-10080). ()
81-10081: If more precise than day, **SHOULD** include time-zone offset (CONF:81-10081). ()
48. Act.participant:participant1.participantRole
Comments

SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
50. Act.participant:participant1.participantRole.classCode
Control1..1
BindingThe codes SHALL be taken from RoleClassRoot
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueROL
52. Act.participant:participant1.participantRole.id
Comments

This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
54. Act.participant:participant1.participantRole.playingEntity
Comments

This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
56. Act.participant:participant1.participantRole.playingEntity.classCode
Control1..1
BindingThe codes SHALL be taken from EntityClassRoot
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueENT
58. Act.participant:participant1.participantRole.playingEntity.name
Definition

A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).

ShortBase for all types and resources
Comments

The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pn-no-ls: No PN name part may have a qualifier of LS. ((delimiter | family | given | prefix | suffix).where(qualifier = 'LS').empty())
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). ()
60. Act.entryRelationship
Comments

SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ encounter
  • value @ typeCode
  • value @ inversionInd
62. Act.entryRelationship:entryRelationship1
Slice NameentryRelationship1
ShortentryRelationship
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
64. Act.entryRelationship:entryRelationship1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueCOMP
66. Act.entryRelationship:entryRelationship1.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Comments

SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

Control1..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuetrue
68. Act.entryRelationship:entryRelationship1.negationInd
Comments

MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
70. Act.entryRelationship:entryRelationship1.encounter
Comments

SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
72. Act.entryRelationship:entryRelationship1.encounter.classCode
Control1..1
BindingThe codes SHALL be taken from ActClass
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueENC
74. Act.entryRelationship:entryRelationship1.encounter.moodCode
Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
76. Act.entryRelationship:entryRelationship1.encounter.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).


Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Control10..*1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
Is Modifierfalse
Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
78. Act.reference
Comments

MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
SlicingThis element introduces a set of slices on Act.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ externalDocument
80. Act.reference:reference1
Slice Namereference1
Shortreference
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
82. Act.reference:reference1.typeCode
Definition

Element Act.typeCode

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
84. Act.reference:reference1.externalDocument
Comments

SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
86. Act.reference:reference1.externalDocument.classCode
Control1..1
BindingThe codes SHALL be taken from ActClassDocument
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueDOC
88. Act.reference:reference1.externalDocument.id
Comments

This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
90. Act.reference:reference1.externalDocument.code
Comments

This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

Control0..1
BindingUnless not suitable, these codes SHALL be taken from FHIRDocumentTypeCodes
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD

Guidance on how to interpret the contents of this table can be found here

0. Act
Definition

Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control1..1
Is Modifierfalse
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Act.classCode
Definition

Element Act.classCode

Comments

SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueACT
6. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueEVN
8. Act.realmCode
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
10. Act.typeId
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
12. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Comments

SHALL contain exactly one [1..1] templateId (CONF:3250-16933) such that it

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
14. Act.templateId:templateId1
Slice NametemplateId1
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

ShorttemplateId
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
16. Act.templateId:templateId1.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
18. Act.templateId:templateId1.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
20. Act.templateId:templateId1.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
22. Act.templateId:templateId1.root
Definition

A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

Comments

SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.202" (CONF:3250-16934).

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Pattern Value2.16.840.1.113883.10.20.22.4.202
24. Act.templateId:templateId1.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Comments

SHALL contain exactly one [1..1] @extension="2016-11-01" (CONF:3250-16937).

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
Pattern Value2016-11-01
26. Act.id
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
28. Act.code
Comments

SHALL contain exactly one [1..1] code (CONF:3250-16895).

Control1..1
BindingUnless not suitable, these codes SHALL be taken from v3 Code System ActCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
30. Act.code.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
32. Act.code.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Comments

This code SHALL contain exactly one [1..1] @code="34109-9" Note (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:3250-16940).

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
Pattern Value34109-9
34. Act.code.codeSystem
Definition

Specifies the code system that defines the code.

Comments

This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" LOINC (CONF:3250-16941).

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
Pattern Value2.16.840.1.113883.6.1
36. Act.code.codeSystemName
Definition

The common name of the coding system.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Name
38. Act.code.codeSystemVersion
Definition

If applicable, a version descriptor defined specifically for the given code system.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Version
40. Act.code.displayName
Definition

A name or title for the code, under which the sending system shows the code value to its users.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplay Name
42. Act.code.sdtcValueSet
Definition

The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

Control0..1
Typestring(oid: ISO Object Identifier)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
44. Act.code.sdtcValueSetVersion
Definition

The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
46. Act.code.originalText
Definition

The text or phrase used as the basis for the coding.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelOriginal Text
48. Act.code.qualifier
Definition

Specifies additional codes that increase the specificity of the the primary code.

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
LabelQualifier
50. Act.code.translation
Definition

A set of other concept descriptors that translate this concept descriptor into other code systems.

Comments

This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939).

Control0..*
BindingThe codes SHOULD be taken from Note Types
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelTranslation
Invariants3250-16942: If the Note Activity is within a Note Section, the translation SHOULD match or specialize the section code (CONF:3250-16942). ()
3250-16943: If the Note Activity is within a narrative-only section (e.g. Hospital Course), the translation MAY match the section code (CONF:3250-16943). ()
52. Act.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
54. Act.text
Comments

SHALL contain exactly one [1..1] text (CONF:3250-16896).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
56. Act.text.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
58. Act.text.charset
Definition

For character-based encoding types, this property specifies the character set and character encoding used. The charset shall be identified by an Internet Assigned Numbers Authority (IANA) Charset Registration [] in accordance with RFC 2978 [].

Control0..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCharset
60. Act.text.compression
Definition

Indicates whether the raw byte data is compressed, and what compression algorithm was used.

Control0..1
BindingThe codes SHALL be taken from CompressionAlgorithm
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCompression
62. Act.text.integrityCheck
Definition

The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

Control0..1
Typebase64Binary(bin: Binary Data)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelIntegrity Check
64. Act.text.integrityCheckAlgorithm
Definition

Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

Control0..1
BindingThe codes SHALL be taken from IntegrityCheckAlgorithm
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelIntegrity Check Algorithm
66. Act.text.language
Definition

For character based information the language property specifies the human language of the text.

Control0..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelLanguage
68. Act.text.mediaType
Definition

Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

Comments

This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

Control0..1
BindingThe codes SHOULD be taken from SupportedFileFormats
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelMedia Type
Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). ()
70. Act.text.representation
Control0..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
72. Act.text.data[x]
Definition

Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

Control0..1
TypeChoice of: string(st: Character String), base64Binary(bin: Binary Data)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as unadorned text.
74. Act.text.reference
Definition

A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

Comments

This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
LabelReference
76. Act.text.reference.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Comments

This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

Control0..0
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
78. Act.text.reference.value
Comments

This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

Control1..1
Typeurl(url: Universal Resource Locator)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Invariants3250-16902: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:3250-16902). ()
80. Act.text.reference.useablePeriod
Definition

Specifies the periods of time during which the telecommunication address can be used. For a telephone number, this can indicate the time of day in which the party can be reached on that telephone. For a web address, it may specify a time range in which the web content is promised to be available under the given address.

Control0..*
TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
Default Typehttp://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelUseable Period
82. Act.text.reference.use
Definition

One or more codes advising a system or user which telecommunication address in a set of like addresses to select for a given telecommunication need.

Control0..*
BindingThe codes SHALL be taken from AddressUse
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelUse Code
84. Act.text.thumbnail
Definition

An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelThumbnail
86. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

Control1..1
BindingThe codes SHALL be taken from ActStatus
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
88. Act.effectiveTime
Comments

SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
90. Act.effectiveTime.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
92. Act.effectiveTime.value
Definition

A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

Comments

This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

Control0..1
Typestring(ts: Point in Time)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
XML FormatIn the XML format, this property is represented as an attribute.
94. Act.effectiveTime.operator
Definition

A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.

Control0..1
BindingThe codes SHALL be taken from SetOperator
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueI
96. Act.effectiveTime.low
Definition

This is the low limit of the interval.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
LabelLow Boundary
98. Act.effectiveTime.center
Definition

The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
LabelCentral Value
100. Act.effectiveTime.width
Definition

The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
LabelWidth
102. Act.effectiveTime.high
Definition

This is the high limit of the interval.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
LabelHigh Boundary
104. Act.priorityCode
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ActPriority
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
106. Act.languageCode
Control0..1
BindingThe codes SHALL be taken from HumanLanguage
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
108. Act.subject
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
110. Act.specimen
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
112. Act.performer
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
114. Act.author
Definition

Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Comments

SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Act.informant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
118. Act.participant
Comments

MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
SlicingThis element introduces a set of slices on Act.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ participantRole
  • value @ typeCode
120. Act.participant:participant1
Slice Nameparticipant1
Shortparticipant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
122. Act.participant:participant1.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
124. Act.participant:participant1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

Control1..1
BindingThe codes SHALL be taken from ParticipationType
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueLA
126. Act.participant:participant1.contextControlCode
Control0..1
BindingThe codes SHALL be taken from ContextControl
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueOP
128. Act.participant:participant1.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
130. Act.participant:participant1.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
132. Act.participant:participant1.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
134. Act.participant:participant1.sdtcFunctionCode
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namefunctionCode.
136. Act.participant:participant1.time
Definition

A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] US Realm Date and Time (DT.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time (DT.US.FIELDED))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ivl-ts-center: Center cannot co-exist with low or high (center.empty() or (low.empty() and high.empty()))
81-10078: **SHALL** be precise to the day (CONF:81-10078). ()
81-10079: **SHOULD** be precise to the minute (CONF:81-10079). ()
81-10080: **MAY** be precise to the second (CONF:81-10080). ()
81-10081: If more precise than day, **SHOULD** include time-zone offset (CONF:81-10081). ()
138. Act.participant:participant1.awarenessCode
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
140. Act.participant:participant1.participantRole
Comments

SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
142. Act.participant:participant1.participantRole.classCode
Control1..1
BindingThe codes SHALL be taken from RoleClassRoot
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueROL
144. Act.participant:participant1.participantRole.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
146. Act.participant:participant1.participantRole.id
Comments

This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
148. Act.participant:participant1.participantRole.sdtcIdentifiedBy
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameidentifiedBy.
150. Act.participant:participant1.participantRole.code
Control0..1
BindingUnless not suitable, these codes SHALL be taken from v3 Code System RoleCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
152. Act.participant:participant1.participantRole.addr
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD
154. Act.participant:participant1.participantRole.telecom
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
156. Act.participant:participant1.participantRole.playingDevice
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Device
158. Act.participant:participant1.participantRole.playingEntity
Comments

This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
160. Act.participant:participant1.participantRole.playingEntity.classCode
Control1..1
BindingThe codes SHALL be taken from EntityClassRoot
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueENT
162. Act.participant:participant1.participantRole.playingEntity.determinerCode
Control0..1
BindingThe codes SHALL be taken from EntityDeterminer
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueINSTANCE
164. Act.participant:participant1.participantRole.playingEntity.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
166. Act.participant:participant1.participantRole.playingEntity.code
Control0..1
BindingUnless not suitable, these codes SHALL be taken from EntityCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
168. Act.participant:participant1.participantRole.playingEntity.quantity
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
170. Act.participant:participant1.participantRole.playingEntity.name
Definition

A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).

ShortBase for all types and resources
Comments

The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pn-no-ls: No PN name part may have a qualifier of LS. ((delimiter | family | given | prefix | suffix).where(qualifier = 'LS').empty())
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). ()
172. Act.participant:participant1.participantRole.playingEntity.sdtcBirthTime
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namebirthTime.
174. Act.participant:participant1.participantRole.playingEntity.desc
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
176. Act.participant:participant1.participantRole.scopingEntity
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Entity
178. Act.entryRelationship
Comments

SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ encounter
  • value @ typeCode
  • value @ inversionInd
180. Act.entryRelationship:entryRelationship1
Slice NameentryRelationship1
ShortentryRelationship
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
182. Act.entryRelationship:entryRelationship1.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
184. Act.entryRelationship:entryRelationship1.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
186. Act.entryRelationship:entryRelationship1.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
188. Act.entryRelationship:entryRelationship1.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
190. Act.entryRelationship:entryRelationship1.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueCOMP
192. Act.entryRelationship:entryRelationship1.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Comments

SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

Control1..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuetrue
194. Act.entryRelationship:entryRelationship1.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
196. Act.entryRelationship:entryRelationship1.negationInd
Comments

MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
198. Act.entryRelationship:entryRelationship1.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
200. Act.entryRelationship:entryRelationship1.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
202. Act.entryRelationship:entryRelationship1.act
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
204. Act.entryRelationship:entryRelationship1.encounter
Comments

SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
206. Act.entryRelationship:entryRelationship1.encounter.classCode
Control1..1
BindingThe codes SHALL be taken from ActClass
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueENC
208. Act.entryRelationship:entryRelationship1.encounter.moodCode
Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
210. Act.entryRelationship:entryRelationship1.encounter.realmCode
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
212. Act.entryRelationship:entryRelationship1.encounter.typeId
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
214. Act.entryRelationship:entryRelationship1.encounter.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
216. Act.entryRelationship:entryRelationship1.encounter.id
Comments

This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
218. Act.entryRelationship:entryRelationship1.encounter.code
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
220. Act.entryRelationship:entryRelationship1.encounter.text
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
222. Act.entryRelationship:entryRelationship1.encounter.statusCode
Control0..1
BindingThe codes SHALL be taken from ActStatus
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
224. Act.entryRelationship:entryRelationship1.encounter.effectiveTime
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
226. Act.entryRelationship:entryRelationship1.encounter.sdtcDischargeDispositionCode
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namedischargeDispositionCode.
228. Act.entryRelationship:entryRelationship1.encounter.priorityCode
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ActPriority
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
230. Act.entryRelationship:entryRelationship1.encounter.subject
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
232. Act.entryRelationship:entryRelationship1.encounter.specimen
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
234. Act.entryRelationship:entryRelationship1.encounter.performer
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
236. Act.entryRelationship:entryRelationship1.encounter.author
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
238. Act.entryRelationship:entryRelationship1.encounter.informant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
240. Act.entryRelationship:entryRelationship1.encounter.participant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
242. Act.entryRelationship:entryRelationship1.encounter.entryRelationship
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
244. Act.entryRelationship:entryRelationship1.encounter.reference
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
246. Act.entryRelationship:entryRelationship1.encounter.precondition
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
248. Act.entryRelationship:entryRelationship1.observation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
250. Act.entryRelationship:entryRelationship1.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
252. Act.entryRelationship:entryRelationship1.organizer
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
254. Act.entryRelationship:entryRelationship1.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
256. Act.entryRelationship:entryRelationship1.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
258. Act.entryRelationship:entryRelationship1.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
260. Act.entryRelationship:entryRelationship1.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
262. Act.reference
Comments

MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
SlicingThis element introduces a set of slices on Act.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ externalDocument
264. Act.reference:reference1
Slice Namereference1
Shortreference
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
266. Act.reference:reference1.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from NullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
268. Act.reference:reference1.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
270. Act.reference:reference1.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
272. Act.reference:reference1.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
274. Act.reference:reference1.typeCode
Definition

Element Act.typeCode

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
276. Act.reference:reference1.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
278. Act.reference:reference1.externalAct
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
280. Act.reference:reference1.externalObservation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
282. Act.reference:reference1.externalProcedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
284. Act.reference:reference1.externalDocument
Comments

SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
286. Act.reference:reference1.externalDocument.classCode
Control1..1
BindingThe codes SHALL be taken from ActClassDocument
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default ValueDOC
288. Act.reference:reference1.externalDocument.moodCode
Control0..1
BindingThe codes SHALL be taken from ActMood
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueEVN
290. Act.reference:reference1.externalDocument.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
292. Act.reference:reference1.externalDocument.id
Comments

This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
294. Act.reference:reference1.externalDocument.code
Comments

This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

Control0..1
BindingUnless not suitable, these codes SHALL be taken from FHIRDocumentTypeCodes
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
296. Act.reference:reference1.externalDocument.text
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
298. Act.reference:reference1.externalDocument.setId
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
300. Act.reference:reference1.externalDocument.versionNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
302. Act.precondition
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition