Consolidated CDA Release 2.2
2.2 - CI Build United States of America flag

Consolidated CDA Release 2.2, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.2). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.2/ and changes regularly. See the Directory of published versions

Resource Profile: Planned Coverage

Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.129 Version: 2.2
Active as of 2022-05-13 Computable Name: PlannedCoverage
Other Identifiers: : urn:oid:2.16.840.1.113883.10.20.22.4.129

This template represents the insurance coverage intended to cover an act or procedure.

Usage:

Formal Views of Profile Content

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

This structure is derived from CDAR2.Act

Summary

Mandatory: 19 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 value of value:root
  • The element Act.entryRelationship is sliced based on the value of profile:act

This structure is derived from CDAR2.Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.Act
... classCode 1..1codeRequired Pattern: ACT
... moodCode 1..1codeRequired Pattern: INT
... Slices for templateId 0..*IISlice: Unordered, Open by value:root
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.129
... code 1..1CD
.... code 1..1stringRequired Pattern: 48768-6
.... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
... statusCode 1..1CS
.... code 1..1stringRequired Pattern: active
... author 0..*AuthorParticipation
... Slices for entryRelationship 0..*ElementSlice: Unordered, Open by profile:act
.... entryRelationship:entryRelationship1 1..1Element
..... typeCode 1..1codeRequired Pattern: COMP
..... act 1..1Act
...... classCode 1..1codeRequired Pattern: ACT
...... moodCode 1..1codeRequired Pattern: INT
...... id 1..*IIThese act/identifiers are unique identifiers for the policy or program providing the coverage.
...... code 1..1CDBinding: Payer (required)
...... statusCode 1..1CS
....... code 1..1stringRequired Pattern: active

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.Act
... classCode 1..1codeRequired Pattern: ACT
... moodCode 1..1codeRequired Pattern: INT
... realmCode 0..*CS
... Slices for templateId 0..*IISlice: Unordered, Open by value:root
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.129
..... extension 0..1string
... id 1..*II
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: 48768-6
.... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... translation 0..*CD
... negationInd 0..1boolean
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: active
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1IVL_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... languageCode 0..1CSBinding: HumanLanguage (required)
... subject 0..1Element
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipation
... informant 0..*Element
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... participant 0..*Participant2
... Slices for entryRelationship I0..*ElementSlice: Unordered, Open by profile:act
.... entryRelationship:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... (Choice of one) 1..1
...... observation 0..1Observation
...... regionOfInterest 0..1RegionOfInterest
...... observationMedia 0..1ObservationMedia
...... substanceAdministration 0..1SubstanceAdministration
...... supply 0..1Supply
...... procedure 0..1Procedure
...... encounter 0..1Encounter
...... organizer 0..1Organizer
...... act 0..1Act
.... entryRelationship:entryRelationship1 I1..1Element
..... typeCode 1..1codeRequired Pattern: COMP
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... act 1..1Act
...... classCode 1..1codeRequired Pattern: ACT
...... moodCode 1..1codeRequired Pattern: INT
...... realmCode 0..*CS
...... typeId 0..1II
...... templateId 0..*II
...... id 1..*IIThese act/identifiers are unique identifiers for the policy or program providing the coverage.
...... code 1..1CDBinding: Payer (required)
...... negationInd 0..1boolean
...... text 0..1ED
...... statusCode 1..1CSBinding: ActStatus (required)
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... code 1..1stringRequired Pattern: active
....... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
....... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
...... effectiveTime 0..1IVL_TS
...... priorityCode 0..1CEBinding: ActPriority (extensible)
...... languageCode 0..1CSBinding: HumanLanguage (required)
...... subject 0..1Element
....... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
....... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
....... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
....... relatedSubject 1..1RelatedSubject
...... specimen 0..*Specimen
...... performer 0..*Performer2
...... author 0..*Author
...... informant 0..*Element
....... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
....... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
....... assignedEntity 0..1AssignedEntity
....... relatedEntity 0..1RelatedEntity
...... participant 0..*Participant2
...... entryRelationship I0..*Element
....... typeCode 1..1code
....... inversionInd 0..1boolean
....... contextConductionInd 1..1boolean
....... sequenceNumber 0..1INT
....... negationInd 0..1boolean
....... seperatableInd 0..1BL
....... (Choice of one) 1..1
........ observation 0..1Observation
........ regionOfInterest 0..1RegionOfInterest
........ observationMedia 0..1ObservationMedia
........ substanceAdministration 0..1SubstanceAdministration
........ supply 0..1Supply
........ procedure 0..1Procedure
........ encounter 0..1Encounter
........ organizer 0..1Organizer
........ act 0..1Act
...... reference 0..*Element
....... typeCode 1..1code
....... seperatableInd 0..1BL
....... externalAct 0..1ExternalAct
....... externalObservation 0..1ExternalObservation
....... externalProcedure 0..1ExternalProcedure
....... externalDocument 0..1ExternalDocument
...... precondition 0..*Precondition
... reference 0..*Element
.... typeCode 1..1code
.... seperatableInd 0..1BL
.... externalAct 0..1ExternalAct
.... externalObservation 0..1ExternalObservation
.... externalProcedure 0..1ExternalProcedure
.... externalDocument 0..1ExternalDocument
... precondition 0..*Precondition

doco Documentation for this format

This structure is derived from CDAR2.Act

Summary

Mandatory: 19 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 value of value:root
  • The element Act.entryRelationship is sliced based on the value of profile:act

Differential View

This structure is derived from CDAR2.Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.Act
... classCode 1..1codeRequired Pattern: ACT
... moodCode 1..1codeRequired Pattern: INT
... Slices for templateId 0..*IISlice: Unordered, Open by value:root
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.129
... code 1..1CD
.... code 1..1stringRequired Pattern: 48768-6
.... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
... statusCode 1..1CS
.... code 1..1stringRequired Pattern: active
... author 0..*AuthorParticipation
... Slices for entryRelationship 0..*ElementSlice: Unordered, Open by profile:act
.... entryRelationship:entryRelationship1 1..1Element
..... typeCode 1..1codeRequired Pattern: COMP
..... act 1..1Act
...... classCode 1..1codeRequired Pattern: ACT
...... moodCode 1..1codeRequired Pattern: INT
...... id 1..*IIThese act/identifiers are unique identifiers for the policy or program providing the coverage.
...... code 1..1CDBinding: Payer (required)
...... statusCode 1..1CS
....... code 1..1stringRequired Pattern: active

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Act 1..1CDAR2.Act
... classCode 1..1codeRequired Pattern: ACT
... moodCode 1..1codeRequired Pattern: INT
... realmCode 0..*CS
... Slices for templateId 0..*IISlice: Unordered, Open by value:root
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.129
..... extension 0..1string
... id 1..*II
... code 1..1CDBinding: v3 Code System ActCode (extensible)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: 48768-6
.... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... translation 0..*CD
... negationInd 0..1boolean
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: active
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 0..1IVL_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... languageCode 0..1CSBinding: HumanLanguage (required)
... subject 0..1Element
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipation
... informant 0..*Element
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... participant 0..*Participant2
... Slices for entryRelationship I0..*ElementSlice: Unordered, Open by profile:act
.... entryRelationship:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... (Choice of one) 1..1
...... observation 0..1Observation
...... regionOfInterest 0..1RegionOfInterest
...... observationMedia 0..1ObservationMedia
...... substanceAdministration 0..1SubstanceAdministration
...... supply 0..1Supply
...... procedure 0..1Procedure
...... encounter 0..1Encounter
...... organizer 0..1Organizer
...... act 0..1Act
.... entryRelationship:entryRelationship1 I1..1Element
..... typeCode 1..1codeRequired Pattern: COMP
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... act 1..1Act
...... classCode 1..1codeRequired Pattern: ACT
...... moodCode 1..1codeRequired Pattern: INT
...... realmCode 0..*CS
...... typeId 0..1II
...... templateId 0..*II
...... id 1..*IIThese act/identifiers are unique identifiers for the policy or program providing the coverage.
...... code 1..1CDBinding: Payer (required)
...... negationInd 0..1boolean
...... text 0..1ED
...... statusCode 1..1CSBinding: ActStatus (required)
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... code 1..1stringRequired Pattern: active
....... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
....... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
...... effectiveTime 0..1IVL_TS
...... priorityCode 0..1CEBinding: ActPriority (extensible)
...... languageCode 0..1CSBinding: HumanLanguage (required)
...... subject 0..1Element
....... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
....... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
....... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
....... relatedSubject 1..1RelatedSubject
...... specimen 0..*Specimen
...... performer 0..*Performer2
...... author 0..*Author
...... informant 0..*Element
....... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
....... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
....... assignedEntity 0..1AssignedEntity
....... relatedEntity 0..1RelatedEntity
...... participant 0..*Participant2
...... entryRelationship I0..*Element
....... typeCode 1..1code
....... inversionInd 0..1boolean
....... contextConductionInd 1..1boolean
....... sequenceNumber 0..1INT
....... negationInd 0..1boolean
....... seperatableInd 0..1BL
....... (Choice of one) 1..1
........ observation 0..1Observation
........ regionOfInterest 0..1RegionOfInterest
........ observationMedia 0..1ObservationMedia
........ substanceAdministration 0..1SubstanceAdministration
........ supply 0..1Supply
........ procedure 0..1Procedure
........ encounter 0..1Encounter
........ organizer 0..1Organizer
........ act 0..1Act
...... reference 0..*Element
....... typeCode 1..1code
....... seperatableInd 0..1BL
....... externalAct 0..1ExternalAct
....... externalObservation 0..1ExternalObservation
....... externalProcedure 0..1ExternalProcedure
....... externalDocument 0..1ExternalDocument
...... precondition 0..*Precondition
... reference 0..*Element
.... typeCode 1..1code
.... seperatableInd 0..1BL
.... externalAct 0..1ExternalAct
.... externalObservation 0..1ExternalObservation
.... externalProcedure 0..1ExternalProcedure
.... externalDocument 0..1ExternalDocument
... precondition 0..*Precondition

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
Act.templateId:primary.nullFlavorrequiredNullFlavor
Act.codeextensibleActCode
Act.code.nullFlavorrequiredNullFlavor
Act.statusCoderequiredActStatus
Act.statusCode.nullFlavorrequiredNullFlavor
Act.priorityCodeextensibleActPriority
Act.languageCoderequiredHumanLanguage
Act.subject.typeCoderequiredFixed Value: SBJ
Act.subject.contextControlCoderequiredFixed Value: OP
Act.subject.awarenessCodeextensibleTargetAwareness
Act.informant.typeCoderequiredFixed Value: INF
Act.informant.contextControlCoderequiredFixed Value: OP
Act.entryRelationship:entryRelationship1.act.coderequiredPayer
Act.entryRelationship:entryRelationship1.act.statusCoderequiredActStatus
Act.entryRelationship:entryRelationship1.act.statusCode.nullFlavorrequiredNullFlavor
Act.entryRelationship:entryRelationship1.act.priorityCodeextensibleActPriority
Act.entryRelationship:entryRelationship1.act.languageCoderequiredHumanLanguage
Act.entryRelationship:entryRelationship1.act.subject.typeCoderequiredFixed Value: SBJ
Act.entryRelationship:entryRelationship1.act.subject.contextControlCoderequiredFixed Value: OP
Act.entryRelationship:entryRelationship1.act.subject.awarenessCodeextensibleTargetAwareness
Act.entryRelationship:entryRelationship1.act.informant.typeCoderequiredFixed Value: INF
Act.entryRelationship:entryRelationship1.act.informant.contextControlCoderequiredFixed Value: OP

Constraints

IdGradePathDetailsRequirements
act-er-1errorAct.entryRelationshipOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
act-er-1errorAct.entryRelationship:entryRelationship1Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
act-er-1errorAct.entryRelationship:entryRelationship1.act.entryRelationshipOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1