CDA Examples
1.0.0 - active
CDA Examples
1.0.0 - active
CDA Examples, published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-Examples/ and changes regularly. See the Directory of published versions
This is an example of an allergy to a drug class (penicillins) using SNOMED CT as terminology with information on both allergic reaction and reaction severity. See DSTU 219 for update regarding act/code
This file includes examples of the following templates:
<section xmlns="urn:hl7-org:v3">
<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
<templateId root="2.16.840.1.113883.10.20.22.2.6.1" extension="2015-08-01"/>
<!-- Allergies (entries required) section template -->
<code codeSystem="2.16.840.1.113883.6.1" code="48765-2"/>
<title>Allergies, Adverse Reactions and Alerts</title>
<text>
<table>
<thead>
<tr>
<th>Allergen</th>
<th>Reaction</th>
<th>Reaction Severity</th>
<th>Documentation Date</th>
<th>Start Date</th>
</tr>
</thead>
<tbody>
<tr ID="allergy3">
<td ID="allergy3allergen">Penicillins (drug class)</td>
<td ID="allergy3reaction">Anaphylaxis</td>
<td ID="allergy3reactionseverity">Severe</td>
<td>Jan 4 2014</td>
<td>2006</td>
</tr>
</tbody>
</table>
</text>
<entry typeCode="DRIV">
<act moodCode="EVN" classCode="ACT">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<templateId root="2.16.840.1.113883.10.20.22.4.30"
extension="2015-08-01"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code codeSystem="2.16.840.1.113883.5.6" code="CONC"/>
<text>
<reference value="#allergy3"/>
</text>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern -->
<effectiveTime>
<low value="20140104123506-0500"/>
</effectiveTime>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20140104"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="99999999"/>
<code displayName="Family Medicine Physician"
codeSystemName="Health Care Provider Taxonomy" codeSystem="2.16.840.1.113883.6.101" code="207Q00000X"/>
<addr nullFlavor="UNK"/>
<telecom value="tel:555-555-1002" use="WP"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<entryRelationship typeCode="SUBJ">
<observation moodCode="EVN" classCode="OBS">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<templateId root="2.16.840.1.113883.10.20.22.4.7"
extension="2014-06-09"/>
<!-- Substance or Device Allergy Intolerance Observation Template -->
<templateId root="2.16.840.1.113883.10.20.24.3.90"
extension="2014-06-09"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.5.4"
code="ASSERTION"/>
<text xsi:type="ED">
<reference value="#allergy3"/>
</text>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="2006"/>
</effectiveTime>
<!-- This specifies that the allergy is to a medication in contrast to other allergies (substance) -->
<value xsi:type="CD" displayName="Allergy to drug"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="416098002"/>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20140104"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="99999999"/>
<code displayName="Family Medicine Physician"
codeSystemName="Health Care Provider Taxonomy" codeSystem="2.16.840.1.113883.6.101" code="207Q00000X"/>
<addr nullFlavor="UNK"/>
<telecom value="tel:555-555-1002" use="WP"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- SNOMED CT is used to report drug class allergies. Note to use RxNorm for specific drugs -->
<code displayName="Penicillin" codeSystemName="SNOMED CT"
codeSystem="2.16.840.1.113883.6.96" code="764146007">
<originalText>
<reference value="#allergy3allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<templateId root="2.16.840.1.113883.10.20.22.4.9"
extension="2014-06-09"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.5.4"
code="ASSERTION"/>
<text xsi:type="ED">
<reference value="#allergy3reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="2006"/>
<high nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD" displayName="Anaphylaxis"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="39579001"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<templateId root="2.16.840.1.113883.10.20.22.4.8"
extension="2014-06-09"/>
<code xsi:type="CD" codeSystemName="ActCode"
codeSystem="2.16.840.1.113883.5.4" code="SEV"/>
<text xsi:type="ED">
<reference value="#allergy3reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" displayName="Severe"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="24484000"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
</section>
IG © Health Level Seven. Package hl7.cda.examples#1.0.0 based on FHIR 5.0.0. Generated 2025-09-17
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