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: Policy Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PolicyActivity Version: 2.1
Draft as of 2023-09-29 Computable Name: PolicyActivity
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.61:2023-05-01

A policy activity represents the policy or program providing the coverage. The person for whom payment is being provided (i.e., the patient) is the covered party. The subscriber of the policy or program is represented as a participant that is the holder of the coverage. The payer is represented as the performer of the policy activity.

Usage:

Formal Views of Profile Content

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

This structure is derived from CDAR2.Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
... classCode 1..1csFixed Value: ACT
... moodCode 1..1csFixed Value: EVN
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... extension 1..1stRequired Pattern: 2023-05-01
... code 1..1CD
.... codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... code 0..1csBinding: Payer (preferred)
... statusCode 1..1CS
.... code 1..1csFixed Value: completed
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... typeCode 1..1cs
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
...... extension 0..0
..... assignedEntity 1..1AssignedEntity
...... id 1..*II
...... code 0..1CE
....... code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... representedOrganization 0..1Organization
....... name 0..1ON
.... performer:performer2 0..*Performer2performer
..... typeCode 1..1cs
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
...... extension 0..0
..... time 0..1IVL_TS
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... code 1..1CE
....... code 1..1csRequired Pattern: GUAR
....... codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... typeCode 1..1csFixed Value: COV
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
...... extension 0..0
..... time 0..1IVL_TS
...... low 0..1IVXB_TS
...... high 0..1IVXB_TS
..... participantRole 1..1ParticipantRole
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code 1..1CE
....... code 0..1csBinding: Coverage Role Type Value Set (preferred)
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... playingEntity 0..1PlayingEntity
....... name 1..1PN
....... sdtcBirthTime C1..1TSsdtc:birthTime
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... typeCode 1..1csFixed Value: HLD
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
...... extension 0..0
..... time 0..1IVL_TS
..... participantRole 1..1ParticipantRole
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... typeCode 1..1csFixed Value: REFR

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Act.code.translation:translation1.codepreferredPayer
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:
NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csFixed Value: ACT
... @moodCode 1..1csFixed Value: EVN
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1stRequired Pattern: 2023-05-01
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... @code 0..1csBinding: Payer (preferred)
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csFixed Value: completed
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
..... assignedEntity 1..1AssignedEntity
...... id 1..*II
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... representedOrganization 0..1Organization
....... name 0..1ON
.... performer:performer2 0..*Performer2performer
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
..... time 0..1IVL_TS
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... id 1..*II
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 1..1csRequired Pattern: GUAR
....... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: COV
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
..... time 0..1IVL_TS
...... low 0..1IVXB_TS
...... high 0..1IVXB_TS
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 0..1csBinding: Coverage Role Type Value Set (preferred)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... playingEntity 0..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... name 1..1PN
....... sdtcBirthTime C1..1TSXML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: HLD
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
..... time 0..1IVL_TS
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Act.codeextensibleActCode
Act.code.translation:translation1.codepreferredPayer
Act.statusCoderequiredActStatus
Act.performer:performer1.typeCoderequiredFixed Value: PRF
Act.performer:performer1.assignedEntity.codeextensibleRoleCode
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.performer:performer2.typeCoderequiredFixed Value: PRF
Act.performer:performer2.assignedEntity.codeextensibleRoleCode
Act.participant:participant1.typeCoderequiredFixed Value: COV
Act.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant1.participantRole.codeextensibleRoleCode
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set
Act.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Act.participant:participant2.typeCoderequiredFixed Value: HLD
Act.participant:participant2.participantRole.classCoderequiredRoleClassRoot
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:
81-7296errorAct.performer:performer1.assignedEntity.addr, Act.performer:performer2.assignedEntity.addr, Act.participant:participant1.participantRole.addr, Act.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @nullFlavor 0..1csBinding: NullFlavor (required)
... @classCode 1..1csFixed Value: ACT
... @moodCode 1..1csFixed Value: EVN
... typeId 0..1II
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1stRequired Pattern: 2023-05-01
... id 1..*II
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 0..1cs
.... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @code 0..1csBinding: Payer (preferred)
...... @codeSystem 0..1oid, uuid, ruid
...... @codeSystemName 0..1st
...... @codeSystemVersion 0..1st
...... @displayName 0..1st
...... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
...... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... @negationInd 0..1bl
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 1..1csFixed Value: completed
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1IVL_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... languageCode 0..1CSBinding: HumanLanguage (required)
... subject 0..1Subject
... specimen 0..*Specimen
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... modeCode 0..1CE
..... assignedEntity 1..1AssignedEntity
...... @classCode 0..1csBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... templateId 0..*II
...... id 1..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
....... @codeSystem 0..1oid, uuid, ruid
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... assignedPerson 0..1Person
...... representedOrganization 0..1Organization
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @classCode 0..1csBinding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... realmCode 0..*CS
....... typeId 0..1II
....... templateId 0..*II
....... id 0..*II
....... name 0..1ON
....... telecom 0..*TEL
....... addr 0..*AD
....... standardIndustryClassCode 0..1CEBinding: OrganizationIndustryClassNAICS (extensible)
....... asOrganizationPartOf 0..1OrganizationPartOf
.... performer:performer2 0..*Performer2performer
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... modeCode 0..1CE
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... @classCode 0..1csBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... templateId 0..*II
...... id 1..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 1..1csRequired Pattern: GUAR
....... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... assignedPerson 0..1Person
...... representedOrganization 0..1Organization
... author 0..*Author
... informant 0..*Informant
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @value 0..1tsDate Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1csBinding: SetOperator (required)
...... low 0..1IVXB_TS
...... center 0..1TS
...... width 0..1PQ
...... high 0..1IVXB_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 0..1csBinding: Coverage Role Type Value Set (preferred)
....... @codeSystem 0..1oid, uuid, ruid
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: EntityCode (extensible)
....... quantity 0..*PQ
....... name 1..1PN
....... sdtcBirthTime C1..1TSXML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
...... scopingEntity 0..1Entity
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
... reference 0..*Reference
... precondition 0..*Precondition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Act.nullFlavorrequiredNullFlavor
Act.templateId:templateId1.nullFlavorrequiredNullFlavor
Act.codeextensibleActCode
Act.code.nullFlavorrequiredNullFlavor
Act.code.translation:translation1.nullFlavorrequiredNullFlavor
Act.code.translation:translation1.codepreferredPayer
Act.statusCoderequiredActStatus
Act.statusCode.nullFlavorrequiredNullFlavor
Act.priorityCodeextensibleActPriority
Act.languageCoderequiredHumanLanguage (a valid code from http://terminology.hl7.org/CodeSystem/ietf3066)
Act.performer:performer1.nullFlavorrequiredNullFlavor
Act.performer:performer1.typeCoderequiredFixed Value: PRF
Act.performer:performer1.templateId.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Act.performer:performer1.assignedEntity.codeextensibleRoleCode
Act.performer:performer1.assignedEntity.code.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.performer:performer1.assignedEntity.representedOrganization.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
Act.performer:performer1.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
Act.performer:performer1.assignedEntity.representedOrganization.standardIndustryClassCodeextensibleOrganizationIndustryClassNAICS
Act.performer:performer2.nullFlavorrequiredNullFlavor
Act.performer:performer2.typeCoderequiredFixed Value: PRF
Act.performer:performer2.templateId.nullFlavorrequiredNullFlavor
Act.performer:performer2.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Act.performer:performer2.assignedEntity.codeextensibleRoleCode
Act.performer:performer2.assignedEntity.code.nullFlavorrequiredNullFlavor
Act.participant:participant1.nullFlavorrequiredNullFlavor
Act.participant:participant1.typeCoderequiredFixed Value: COV
Act.participant:participant1.contextControlCoderequiredFixed Value: OP
Act.participant:participant1.templateId.nullFlavorrequiredNullFlavor
Act.participant:participant1.time.nullFlavorrequiredNullFlavor
Act.participant:participant1.time.operatorrequiredSetOperator
Act.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant1.participantRole.codeextensibleRoleCode
Act.participant:participant1.participantRole.code.nullFlavorrequiredNullFlavor
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set
Act.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Act.participant:participant1.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Act.participant:participant1.participantRole.playingEntity.codeextensibleEntityCode
Act.participant:participant2.nullFlavorrequiredNullFlavor
Act.participant:participant2.typeCoderequiredFixed Value: HLD
Act.participant:participant2.contextControlCoderequiredFixed Value: OP
Act.participant:participant2.templateId.nullFlavorrequiredNullFlavor
Act.participant:participant2.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant2.participantRole.codeextensibleRoleCode
Act.entryRelationship:entryRelationship1.nullFlavorrequiredNullFlavor
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:
81-7296errorAct.performer:performer1.assignedEntity.addr, Act.performer:performer2.assignedEntity.addr, Act.participant:participant1.participantRole.addr, Act.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

This structure is derived from CDAR2.Act

Summary

Mandatory: 22 elements (13 nested mandatory elements)
Fixed Value: 6 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Act.templateId is sliced based on the values of value:root, value:extension
  • The element Act.code.translation is sliced based on the value of value:code
  • The element Act.performer is sliced based on the values of value:templateId, value:assignedEntity, value:typeCode
  • The element Act.participant is sliced based on the values of value:templateId, value:participantRole, value:typeCode
  • The element Act.entryRelationship is sliced based on the value of value:typeCode

Differential View

This structure is derived from CDAR2.Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
... classCode 1..1csFixed Value: ACT
... moodCode 1..1csFixed Value: EVN
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... extension 1..1stRequired Pattern: 2023-05-01
... code 1..1CD
.... codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... code 0..1csBinding: Payer (preferred)
... statusCode 1..1CS
.... code 1..1csFixed Value: completed
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... typeCode 1..1cs
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
...... extension 0..0
..... assignedEntity 1..1AssignedEntity
...... id 1..*II
...... code 0..1CE
....... code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... representedOrganization 0..1Organization
....... name 0..1ON
.... performer:performer2 0..*Performer2performer
..... typeCode 1..1cs
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
...... extension 0..0
..... time 0..1IVL_TS
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... code 1..1CE
....... code 1..1csRequired Pattern: GUAR
....... codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... typeCode 1..1csFixed Value: COV
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
...... extension 0..0
..... time 0..1IVL_TS
...... low 0..1IVXB_TS
...... high 0..1IVXB_TS
..... participantRole 1..1ParticipantRole
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code 1..1CE
....... code 0..1csBinding: Coverage Role Type Value Set (preferred)
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... playingEntity 0..1PlayingEntity
....... name 1..1PN
....... sdtcBirthTime C1..1TSsdtc:birthTime
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... typeCode 1..1csFixed Value: HLD
..... templateId 1..1II
...... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
...... extension 0..0
..... time 0..1IVL_TS
..... participantRole 1..1ParticipantRole
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr 0..1USRealmAddressADUSFIELDEDBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... typeCode 1..1csFixed Value: REFR

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Act.code.translation:translation1.codepreferredPayer
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csFixed Value: ACT
... @moodCode 1..1csFixed Value: EVN
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1stRequired Pattern: 2023-05-01
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... @code 0..1csBinding: Payer (preferred)
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csFixed Value: completed
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
..... assignedEntity 1..1AssignedEntity
...... id 1..*II
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... representedOrganization 0..1Organization
....... name 0..1ON
.... performer:performer2 0..*Performer2performer
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
..... time 0..1IVL_TS
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... id 1..*II
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 1..1csRequired Pattern: GUAR
....... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: COV
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
..... time 0..1IVL_TS
...... low 0..1IVXB_TS
...... high 0..1IVXB_TS
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @code 0..1csBinding: Coverage Role Type Value Set (preferred)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... playingEntity 0..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... name 1..1PN
....... sdtcBirthTime C1..1TSXML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: HLD
..... templateId 1..1II
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
..... time 0..1IVL_TS
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Act.codeextensibleActCode
Act.code.translation:translation1.codepreferredPayer
Act.statusCoderequiredActStatus
Act.performer:performer1.typeCoderequiredFixed Value: PRF
Act.performer:performer1.assignedEntity.codeextensibleRoleCode
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.performer:performer2.typeCoderequiredFixed Value: PRF
Act.performer:performer2.assignedEntity.codeextensibleRoleCode
Act.participant:participant1.typeCoderequiredFixed Value: COV
Act.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant1.participantRole.codeextensibleRoleCode
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set
Act.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Act.participant:participant2.typeCoderequiredFixed Value: HLD
Act.participant:participant2.participantRole.classCoderequiredRoleClassRoot
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:
81-7296errorAct.performer:performer1.assignedEntity.addr, Act.performer:performer2.assignedEntity.addr, Act.participant:participant1.participantRole.addr, Act.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.ActXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @nullFlavor 0..1csBinding: NullFlavor (required)
... @classCode 1..1csFixed Value: ACT
... @moodCode 1..1csFixed Value: EVN
... typeId 0..1II
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:templateId1 1..1IItemplateId
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.61
..... @extension 1..1stRequired Pattern: 2023-05-01
... id 1..*II
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 0..1cs
.... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.255.1336
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code
..... translation:translation1 1..*CDtranslation
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @code 0..1csBinding: Payer (preferred)
...... @codeSystem 0..1oid, uuid, ruid
...... @codeSystemName 0..1st
...... @codeSystemVersion 0..1st
...... @displayName 0..1st
...... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
...... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... @negationInd 0..1bl
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 1..1csFixed Value: completed
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1IVL_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... languageCode 0..1CSBinding: HumanLanguage (required)
... subject 0..1Subject
... specimen 0..*Specimen
... Slices for performer 1..*Performer2Slice: Unordered, Open by value:templateId, value:assignedEntity, value:typeCode
.... performer:performer1 1..1Performer2performer
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.87
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... modeCode 0..1CE
..... assignedEntity 1..1AssignedEntity
...... @classCode 0..1csBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... templateId 0..*II
...... id 1..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 1..1csBinding: Financially Responsible Party Type Value Set (preferred)
....... @codeSystem 0..1oid, uuid, ruid
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... assignedPerson 0..1Person
...... representedOrganization 0..1Organization
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @classCode 0..1csBinding: EntityClassOrganization (required)
Fixed Value: ORG
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... realmCode 0..*CS
....... typeId 0..1II
....... templateId 0..*II
....... id 0..*II
....... name 0..1ON
....... telecom 0..*TEL
....... addr 0..*AD
....... standardIndustryClassCode 0..1CEBinding: OrganizationIndustryClassNAICS (extensible)
....... asOrganizationPartOf 0..1OrganizationPartOf
.... performer:performer2 0..*Performer2performer
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.88
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... modeCode 0..1CE
..... assignedEntity C1..1AssignedEntity4537-8967: **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
...... @classCode 0..1csBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
...... templateId 0..*II
...... id 1..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 1..1csRequired Pattern: GUAR
....... @codeSystem 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.5.110
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... assignedPerson 0..1Person
...... representedOrganization 0..1Organization
... author 0..*Author
... informant 0..*Informant
... Slices for participant 1..*Participant2Slice: Unordered, Open by value:templateId, value:participantRole, value:typeCode
.... participant:participant1 1..1Participant2participant
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: COV
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.89
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @value 0..1tsDate Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1csBinding: SetOperator (required)
...... low 0..1IVXB_TS
...... center 0..1TS
...... width 0..1PQ
...... high 0..1IVXB_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id C1..*II4537-8984: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 1..1CEBinding: v3 Code System RoleCode (extensible)
....... @nullFlavor 0..1csBinding: NullFlavor (required)
....... @code 0..1csBinding: Coverage Role Type Value Set (preferred)
....... @codeSystem 0..1oid, uuid, ruid
....... @codeSystemName 0..1st
....... @codeSystemVersion 0..1st
....... @displayName 0..1st
....... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
....... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
....... originalText 0..1ED
....... translation 0..*CD
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: EntityCode (extensible)
....... quantity 0..*PQ
....... name 1..1PN
....... sdtcBirthTime C1..1TSXML Namespace: urn:hl7-org:sdtc
sdtc:birthTime
XML: birthTime (urn:hl7-org:sdtc)
4537-31345: The prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 C0..1Participant2participant
4537-17139: When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: HLD
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 1..1II
...... @nullFlavor 0..1csBinding: NullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.90
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id C1..*II4537-10120: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: v3 Code System RoleCode (extensible)
...... addr C0..1USRealmAddressADUSFIELDEDBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
...... scopingEntity 0..1Entity
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by value:typeCode
.... entryRelationship:entryRelationship1 C0..*EntryRelationshipentryRelationship
4537-8942: The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
4537-8943: A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
... reference 0..*Reference
... precondition 0..*Precondition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Act.nullFlavorrequiredNullFlavor
Act.templateId:templateId1.nullFlavorrequiredNullFlavor
Act.codeextensibleActCode
Act.code.nullFlavorrequiredNullFlavor
Act.code.translation:translation1.nullFlavorrequiredNullFlavor
Act.code.translation:translation1.codepreferredPayer
Act.statusCoderequiredActStatus
Act.statusCode.nullFlavorrequiredNullFlavor
Act.priorityCodeextensibleActPriority
Act.languageCoderequiredHumanLanguage (a valid code from http://terminology.hl7.org/CodeSystem/ietf3066)
Act.performer:performer1.nullFlavorrequiredNullFlavor
Act.performer:performer1.typeCoderequiredFixed Value: PRF
Act.performer:performer1.templateId.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Act.performer:performer1.assignedEntity.codeextensibleRoleCode
Act.performer:performer1.assignedEntity.code.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.code.codepreferredFinancially Responsible Party Type Value Set
Act.performer:performer1.assignedEntity.representedOrganization.nullFlavorrequiredNullFlavor
Act.performer:performer1.assignedEntity.representedOrganization.classCoderequiredFixed Value: ORG
Act.performer:performer1.assignedEntity.representedOrganization.determinerCoderequiredFixed Value: INSTANCE
Act.performer:performer1.assignedEntity.representedOrganization.standardIndustryClassCodeextensibleOrganizationIndustryClassNAICS
Act.performer:performer2.nullFlavorrequiredNullFlavor
Act.performer:performer2.typeCoderequiredFixed Value: PRF
Act.performer:performer2.templateId.nullFlavorrequiredNullFlavor
Act.performer:performer2.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Act.performer:performer2.assignedEntity.codeextensibleRoleCode
Act.performer:performer2.assignedEntity.code.nullFlavorrequiredNullFlavor
Act.participant:participant1.nullFlavorrequiredNullFlavor
Act.participant:participant1.typeCoderequiredFixed Value: COV
Act.participant:participant1.contextControlCoderequiredFixed Value: OP
Act.participant:participant1.templateId.nullFlavorrequiredNullFlavor
Act.participant:participant1.time.nullFlavorrequiredNullFlavor
Act.participant:participant1.time.operatorrequiredSetOperator
Act.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant1.participantRole.codeextensibleRoleCode
Act.participant:participant1.participantRole.code.nullFlavorrequiredNullFlavor
Act.participant:participant1.participantRole.code.codepreferredCoverage Role Type Value Set
Act.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Act.participant:participant1.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Act.participant:participant1.participantRole.playingEntity.codeextensibleEntityCode
Act.participant:participant2.nullFlavorrequiredNullFlavor
Act.participant:participant2.typeCoderequiredFixed Value: HLD
Act.participant:participant2.contextControlCoderequiredFixed Value: OP
Act.participant:participant2.templateId.nullFlavorrequiredNullFlavor
Act.participant:participant2.participantRole.classCoderequiredRoleClassRoot
Act.participant:participant2.participantRole.codeextensibleRoleCode
Act.entryRelationship:entryRelationship1.nullFlavorrequiredNullFlavor
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
4537-8942warningAct.entryRelationship:entryRelationship1The target of a policy activity with act/entryRelationship/@typeCode="REFR" **SHALL** be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan (CONF:4537-8942).
:
4537-8943warningAct.entryRelationship:entryRelationship1A description of the coverage plan **SHALL** contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan (CONF:4537-8943).
:
4537-8967warningAct.performer:performer2.assignedEntity**SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967).
:
4537-8984warningAct.participant:participant1.participantRole.idThis id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
:
4537-10120warningAct.participant:participant2.participantRole.idThis id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
:
4537-17139warningAct.participant:participant2When the Subscriber is the patient, the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139).
:
4537-31345errorAct.participant:participant1.participantRole.playingEntity.sdtcBirthTimeThe prefix sdtc: **SHALL** be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element (CONF:4537-31345).
:
81-7296errorAct.performer:performer1.assignedEntity.addr, Act.performer:performer2.assignedEntity.addr, Act.participant:participant1.participantRole.addr, Act.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

This structure is derived from CDAR2.Act

Summary

Mandatory: 22 elements (13 nested mandatory elements)
Fixed Value: 6 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Act.templateId is sliced based on the values of value:root, value:extension
  • The element Act.code.translation is sliced based on the value of value:code
  • The element Act.performer is sliced based on the values of value:templateId, value:assignedEntity, value:typeCode
  • The element Act.participant is sliced based on the values of value:templateId, value:participantRole, value:typeCode
  • The element Act.entryRelationship is sliced based on the value of value:typeCode

 

Other representations of profile: CSV, Excel