Problem Concern Act - Definitions - Consolidated CDA Release 2.1 StructureDefinition Publication v2.1

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: ProblemConcernAct - Detailed Descriptions

Draft as of 2023-09-29

Definitions for the ProblemConcernAct logical model.

Differential Elements Table
Key Elements Table
Snapshot Elements Table

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

0. Act
XML Format	In 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 (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-9024).
Fixed Value	ACT
4. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9025).
Fixed Value	EVN
6. Act.templateId
Control	1..?
Slicing	This 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 @ extension value @ root
8. Act.templateId:primary
Slice Name	primary
Comments	SHALL contain exactly one [1..1] templateId (CONF:1198-16772) such that it
Control	1..1
10. Act.templateId:primary.root
Comments	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.3" (CONF:1198-16773).
Control	1..?
Pattern Value	2.16.840.1.113883.10.20.22.4.3
12. Act.templateId:primary.extension
Comments	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32509).
Control	1..?
Pattern Value	2015-08-01
14. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:1198-9026).
Control	1..?
16. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:1198-9027).
18. Act.code.code
Comments	This code SHALL contain exactly one [1..1] @code="CONC" Concern (CONF:1198-19184).
Control	1..?
Pattern Value	CONC
20. Act.code.codeSystem
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.6" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1198-32168).
Control	1..?
Pattern Value	2.16.840.1.113883.5.6
22. Act.statusCode
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-9029).
Control	1..?
24. Act.statusCode.code
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:1198-31525).
Control	1..?
Binding	The codes SHALL be taken from ProblemAct statusCode
26. Act.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9030).
Control	1..?
28. Act.effectiveTime.low
Short	The effectiveTime/low of the Problem Concern Act asserts when the concern became active.
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-9032).
Control	1..?
30. Act.effectiveTime.high
Short	The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition).
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:1198-9033).
32. Act.author
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-31146).
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
34. Act.entryRelationship
Short	The following entryRelationship represents the importance of the concern to a provider.
Control	1..?
Slicing	This 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: profile @ observation
36. Act.entryRelationship:problem
Slice Name	problem
Comments	SHALL contain exactly one [1..1] entryRelationship (CONF:1198-9034) such that it
Control	1..1
38. Act.entryRelationship:problem.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SUBJ" Has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-9035).
Fixed Value	SUBJ
40. Act.entryRelationship:problem.observation
Comments	SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15980).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)
42. Act.entryRelationship:priority
Slice Name	priority
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:1198-31638) such that it
Control	0..*
44. Act.entryRelationship:priority.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31639).
Fixed Value	REFR
46. Act.entryRelationship:priority.observation
Comments	SHALL contain exactly one [1..1] Priority Preference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.143) (CONF:1198-31640).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Priority Preference)

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.
Short	Base for all types and resources
Control	10..1*
Is Modifier	false
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	ele-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 (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-9024).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	ACT
4. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9025).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	EVN
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
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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 @ extension value @ root
8. Act.templateId:primary
Slice Name	primary
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:1198-16772) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
10. Act.templateId:primary.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="2.16.840.1.113883.10.20.22.4.3" (CONF:1198-16773).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	2.16.840.1.113883.10.20.22.4.3
12. Act.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Comments	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32509).
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	2015-08-01
14. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:1198-9026).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
16. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:1198-9027).
Control	1..1
Binding	Unless not suitable, these codes SHALL be taken from v3 Code System ActCode
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
18. 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="CONC" Concern (CONF:1198-19184).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	CONC
20. Act.code.codeSystem
Definition	Specifies the code system that defines the code.
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.6" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1198-32168).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	2.16.840.1.113883.5.6
22. Act.statusCode
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-9029).
Control	1..1
Binding	The codes SHALL be taken from ActStatus
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
24. Act.statusCode.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.
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:1198-31525).
Control	1..1
Binding	The codes SHALL be taken from ProblemAct statusCode
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
26. Act.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
28. Act.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
30. Act.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
32. Act.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
34. Act.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
36. Act.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
38. Act.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
40. Act.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9030).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
42. Act.effectiveTime.low
Definition	This is the low limit of the interval.
Short	The effectiveTime/low of the Problem Concern Act asserts when the concern became active.
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-9032).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
44. Act.effectiveTime.high
Definition	This is the high limit of the interval.
Short	The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition).
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:1198-9033).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
46. Act.author
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-31146).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Act.entryRelationship
Short	The following entryRelationship represents the importance of the concern to a provider.
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This 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: profile @ observation
50. Act.entryRelationship:problem
Slice Name	problem
Comments	SHALL contain exactly one [1..1] entryRelationship (CONF:1198-9034) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
52. Act.entryRelationship:problem.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SUBJ" Has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-9035).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	SUBJ
54. Act.entryRelationship:problem.observation
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15980).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Act.entryRelationship:priority
Slice Name	priority
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:1198-31638) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
58. Act.entryRelationship:priority.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31639).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	REFR
60. Act.entryRelationship:priority.observation
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Priority Preference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.143) (CONF:1198-31640).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Priority Preference)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)

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.
Short	Base for all types and resources
Control	1..1
Is Modifier	false
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	ele-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.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Act.classCode
Definition	Element Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-9024).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	ACT
6. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9025).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	EVN
8. Act.realmCode
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
10. Act.typeId
Control	0..1
Type	http://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
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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 @ extension value @ root
14. Act.templateId:primary
Slice Name	primary
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:1198-16772) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
16. Act.templateId:primary.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
18. Act.templateId:primary.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
20. Act.templateId:primary.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
22. Act.templateId:primary.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="2.16.840.1.113883.10.20.22.4.3" (CONF:1198-16773).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	2.16.840.1.113883.10.20.22.4.3
24. Act.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Comments	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32509).
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	2015-08-01
26. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:1198-9026).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
28. Act.code
Comments	SHALL contain exactly one [1..1] code (CONF:1198-9027).
Control	1..1
Binding	Unless not suitable, these codes SHALL be taken from v3 Code System ActCode
Type	http://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.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional 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="CONC" Concern (CONF:1198-19184).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	CONC
34. Act.code.codeSystem
Definition	Specifies the code system that defines the code.
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.6" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1198-32168).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	2.16.840.1.113883.5.6
36. Act.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
38. Act.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code 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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display 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.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSet`.
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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSetVersion`.
46. Act.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
48. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
50. Act.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
52. Act.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
54. Act.text
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
56. Act.statusCode
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-9029).
Control	1..1
Binding	The codes SHALL be taken from ActStatus
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
58. Act.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
60. Act.statusCode.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.
Short	The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
Comments	This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:1198-31525).
Control	1..1
Binding	The codes SHALL be taken from ProblemAct statusCode
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
62. Act.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
64. Act.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
66. Act.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
68. Act.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
70. Act.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSet`.
72. Act.statusCode.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.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In 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 name`valueSetVersion`.
74. Act.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
76. Act.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
78. Act.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
80. Act.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9030).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
82. Act.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
84. 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.
Control	0..1
Type	string(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
86. 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.
Control	0..1
Binding	The codes SHALL be taken from SetOperator
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	I
88. Act.effectiveTime.low
Definition	This is the low limit of the interval.
Short	The effectiveTime/low of the Problem Concern Act asserts when the concern became active.
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-9032).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
90. 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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
92. 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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
94. Act.effectiveTime.high
Definition	This is the high limit of the interval.
Short	The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition).
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:1198-9033).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
96. Act.priorityCode
Control	0..1
Binding	Unless not suitable, these codes SHALL be taken from ActPriority
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
98. Act.languageCode
Control	0..1
Binding	The codes SHALL be taken from HumanLanguage
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
100. Act.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
102. Act.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
104. Act.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
106. Act.author
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-31146).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Act.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
110. Act.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
112. Act.entryRelationship
Short	The following entryRelationship represents the importance of the concern to a provider.
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This 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: profile @ observation
114. Act.entryRelationship:problem
Slice Name	problem
Comments	SHALL contain exactly one [1..1] entryRelationship (CONF:1198-9034) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
116. Act.entryRelationship:problem.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
118. Act.entryRelationship:problem.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
120. Act.entryRelationship:problem.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
122. Act.entryRelationship:problem.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
124. Act.entryRelationship:problem.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SUBJ" Has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-9035).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	SUBJ
126. Act.entryRelationship:problem.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.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
128. Act.entryRelationship:problem.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.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	true
130. Act.entryRelationship:problem.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
132. Act.entryRelationship:problem.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
134. Act.entryRelationship:problem.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
136. Act.entryRelationship:problem.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
138. Act.entryRelationship:problem.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
140. Act.entryRelationship:problem.observation
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Problem Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.4:2015-08-01) (CONF:1198-15980).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
142. Act.entryRelationship:problem.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
144. Act.entryRelationship:problem.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
146. Act.entryRelationship:problem.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
148. Act.entryRelationship:problem.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
150. Act.entryRelationship:problem.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
152. Act.entryRelationship:problem.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
154. Act.entryRelationship:priority
Slice Name	priority
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:1198-31638) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
156. Act.entryRelationship:priority.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
158. Act.entryRelationship:priority.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
160. Act.entryRelationship:priority.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.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
162. Act.entryRelationship:priority.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
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
164. Act.entryRelationship:priority.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31639).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	REFR
166. Act.entryRelationship:priority.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.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
168. Act.entryRelationship:priority.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.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	true
170. Act.entryRelationship:priority.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
172. Act.entryRelationship:priority.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
174. Act.entryRelationship:priority.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
176. Act.entryRelationship:priority.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
178. Act.entryRelationship:priority.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
180. Act.entryRelationship:priority.observation
Definition	Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Priority Preference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.143) (CONF:1198-31640).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Priority Preference)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Act.entryRelationship:priority.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
184. Act.entryRelationship:priority.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
186. Act.entryRelationship:priority.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
188. Act.entryRelationship:priority.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
190. Act.entryRelationship:priority.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
192. Act.entryRelationship:priority.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
194. Act.reference
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
196. Act.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition