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 a results panel with Laboratory Location details as required by 2015 Certification Sender test 170.315(e1), in compliance with 42 CFR 493.1291(c)(1) through (7).
This file includes examples of the following templates:
<!-- Results with Lab Location this example shows content from the 2015 Certification Sender test file: 170.315_e1_vdt_amb_sample1_v8.pdf
since the focus of the example is upon the test data statement shown below, multiple actual results values are removed:
Laboratory Location Details for the above Laboratory Results: The laboratory location details are required to meet the 42 CFR 493.1291(c)(1) through (7) requirements identified in the Regulation
-->
<section xmlns="urn:hl7-org:v3">
<!-- ... this component / section is templated as a C-CDA R2.1 Results Section, entries required -->
<templateId root="2.16.840.1.113883.10.20.22.2.3" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3.1" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
<code codeSystem="2.16.840.1.113883.6.1" code="30954-2"/>
<title>Results</title>
<text>
<table>
<!-- the results display in 3 columns:
col 1: Result Organizer detail, containing the ordered test, date/time
col 2: the name and result of the items that are resulted
col 3: additional result details, such as ranges, interpretations, comments -->
<colgroup>
<col width="20%"/>
<col width="40%"/>
<col width="40%"/>
</colgroup>
<tbody>
<tr>
<td>
<content ID="_3ffb46b1-9fe4-45f3-9a0f-e0e492563e7b">Urinanalysis macro (dipstick) panel</content>
<br/>
<content>22-Jun-2015</content>
</td>
<!-- the CLIA requirement for Lab Location is to show the location in the human readable text -->
<td>
<content>Laboratory: </content>
<content> Value Labs</content>
<content> 2474, Rocky place Beaverton OR 97006</content>
<content> tel:+1-(555)666-1002</content>
</td>
<td/>
</tr>
<!-- rows removed just to simplify example -->
<tr ID="_13a52df8-79ed-4689-a9da-14c5905de830">
<td/>
<td>
<content ID="_ea838e08-d5eb-4ed4-a176-e5f9a831a780">Specific gravity of Urine by Test strip</content>
<content> 1.015</content>
</td>
<td>
<content>Range: </content>
<!-- SDWG Example agreed to ID reference here since moving to td would mean text 'Range' is in observation -->
<content ID="_08b7d0ee-aff1-4144-a3a5-c89d56d855ad">
<content>1.005</content>
<content> - </content>
<content>1.030</content>
</content>
<br/>
</td>
</tr>
<!-- rows removed just to simplify example -->
</tbody>
</table>
</text>
<entry>
<!-- components removed to simplify example -->
<organizer moodCode="EVN" classCode="BATTERY">
<templateId root="2.16.840.1.113883.10.20.22.4.1"
extension="2023-05-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.1"
extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.1"/>
<id root="1.3.6.1.4.1.22812.20.1.1.4.5" extension="1"/>
<code codeSystem="2.16.840.1.113883.6.1" code="24357-6">
<originalText>
<!-- reference the text of the organizer code -->
<reference value="#_3ffb46b1-9fe4-45f3-9a0f-e0e492563e7b"/>
</originalText>
</code>
<statusCode code="completed"/>
<effectiveTime>
<!-- if present, this shall contain the range of times of the resulted components -->
<low value="20150622"/>
<high value="20150622"/>
</effectiveTime>
<!-- The lab reporting location and details are recorded here as the lab was the performed of the battery of tests -->
<!-- Receiving systems may see the lab reporting location in the author particitipant since the original 2015 ONC certification suggested the author -->
<!-- Sending systems SHOULD always place the lab reporting location in the performer -->
<performer typeCode="PRF">
<assignedEntity>
<id root="2.16.840.1.113883.19.5"/>
<representedOrganization>
<name>Value Labs</name>
<telecom value="tel:+1-(555)666-1002"/>
<addr>
<streetAddressLine>2474, Rocky place</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
</addr>
</representedOrganization>
</assignedEntity>
</performer>
<!-- components removed to simplify example -->
<component>
<observation moodCode="EVN" classCode="OBS">
<templateId root="2.16.840.1.113883.10.20.22.4.2"
extension="2023-05-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.2"
extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
<id root="1.3.6.1.4.1.22812.20.1.1.4.5" extension="13"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.6.1"
code="5811-5">
<originalText>
<!-- reference the text of the coded component -->
<reference value="#_ea838e08-d5eb-4ed4-a176-e5f9a831a780"/>
</originalText>
</code>
<text xsi:type="ED">
<!-- reference the entire text of the component -->
<reference value="#_13a52df8-79ed-4689-a9da-14c5905de830"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="PQ" value="1.015" unit="1"/>
<referenceRange>
<observationRange>
<text>
<!-- reference the text of the reference range -->
<reference value="#_08b7d0ee-aff1-4144-a3a5-c89d56d855ad"/>
</text>
<value xsi:type="IVL_PQ">
<low value="1.005" unit="1"/>
<high value="1.030" unit="1"/>
</value>
</observationRange>
</referenceRange>
</observation>
</component>
</organizer>
</entry>
</section>
IG © Health Level Seven. Package hl7.cda.examples#1.0.0 based on FHIR 5.0.0. Generated 2025-08-28
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