Consolidated CDA Release 2.2
2.2 - CI Build

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: Nutrition Recommendation

Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.130 | Version: 2.2
Active as of 2022-05-13 | Computable Name: NutritionRecommendation
Other Identifiers: : urn:oid:2.16.840.1.113883.10.20.22.4.130

This template represents nutrition regimens (e.g., fluid restrictions, calorie minimum), interventions (e.g., NPO, nutritional supplements), and procedures (e.g., G-Tube by bolus, TPN by central line). It may also depict the need for nutrition education.

Usage:

- Use this Resource Profile: Plan of Treatment Section, Intervention Act, Planned Intervention Act

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from CDAR2.Act

Summary

Mandatory: 7 elements (12 nested mandatory elements)

Structures

This structure refers to these other structures:

- Planned Encounter (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.40)
- Planned Medication Activity (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.42)
- Planned Observation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.44)
- Planned Procedure (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.41)
- Planned Supply (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.43)
- Planned Act (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.39)

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 values of profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation

This structure is derived from CDAR2.Act

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
classCode |  | 1..1 | code | Required Pattern: ACT
moodCode |  | 1..1 | code | Binding: Planned moodCode (Act/Encounter/Procedure) (required)
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.130
code |  | 1..1 | CD | Binding: Nutrition Recommendations (preferred)
statusCode |  | 1..1 | CS |
code |  | 1..1 | string | Required Pattern: active
effectiveTime |  | 0..1 | IVL_TS | The effectiveTime indicates the time when the activity is intended to take place.
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation
entryRelationship:plannedEncounter |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
encounter |  | 1..1 | PlannedEncounter |
entryRelationship:plannedMedActivity |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
substanceAdministration |  | 1..1 | PlannedMedicationActivity |
entryRelationship:plannedObs |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
observation |  | 1..1 | PlannedObservation |
entryRelationship:plannedProc |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
procedure |  | 1..1 | PlannedProcedure |
entryRelationship:plannedSupply |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
supply |  | 1..1 | PlannedSupply |
entryRelationship:plannedAct |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
act |  | 1..1 | PlannedAct |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
classCode |  | 1..1 | code | Required Pattern: ACT
moodCode |  | 1..1 | code | Binding: Planned moodCode (Act/Encounter/Procedure) (required)
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
assigningAuthorityName |  | 0..1 | string |
displayable |  | 0..1 | boolean |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.130
extension |  | 0..1 | string |
id |  | 0..* | II |
code |  | 1..1 | CD | Binding: Nutrition Recommendations (preferred)
negationInd |  | 0..1 | boolean |
text |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: active
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime |  | 0..1 | IVL_TS | The effectiveTime indicates the time when the activity is intended to take place.
priorityCode |  | 0..1 | CE | Binding: ActPriority (extensible)
languageCode |  | 0..1 | CS | Binding: HumanLanguage (required)
subject |  | 0..1 | Element |
typeCode |  | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ
contextControlCode |  | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP
awarenessCode |  | 0..1 | CE | Binding: TargetAwareness (extensible)
relatedSubject |  | 1..1 | RelatedSubject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Element |
typeCode |  | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF
contextControlCode |  | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP
assignedEntity |  | 0..1 | AssignedEntity |
relatedEntity |  | 0..1 | RelatedEntity |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | I | 0..* | Element | Slice: Unordered, Open by profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation
entryRelationship:All Slices |  |  |  | Content/Rules for all slices
typeCode |  | 1..1 | code |
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
(Choice of one) |  | 1..1 |  |
observation |  | 0..1 | Observation |
regionOfInterest |  | 0..1 | RegionOfInterest |
observationMedia |  | 0..1 | ObservationMedia |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
procedure |  | 0..1 | Procedure |
encounter |  | 0..1 | Encounter |
organizer |  | 0..1 | Organizer |
act |  | 0..1 | Act |
entryRelationship:plannedEncounter | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
encounter |  | 1..1 | PlannedEncounter |
entryRelationship:plannedMedActivity | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
substanceAdministration |  | 1..1 | PlannedMedicationActivity |
entryRelationship:plannedObs | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
observation |  | 1..1 | PlannedObservation |
entryRelationship:plannedProc | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
procedure |  | 1..1 | PlannedProcedure |
entryRelationship:plannedSupply | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
supply |  | 1..1 | PlannedSupply |
entryRelationship:plannedAct | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | PlannedAct |
reference |  | 0..* | Element |
typeCode |  | 1..1 | code |
seperatableInd |  | 0..1 | BL |
externalAct |  | 0..1 | ExternalAct |
externalObservation |  | 0..1 | ExternalObservation |
externalProcedure |  | 0..1 | ExternalProcedure |
externalDocument |  | 0..1 | ExternalDocument |
precondition |  | 0..* | Precondition |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
Documentation for this format

This structure is derived from CDAR2.Act

Summary

Mandatory: 7 elements (12 nested mandatory elements)

Structures

This structure refers to these other structures:

- Planned Encounter (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.40)
- Planned Medication Activity (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.42)
- Planned Observation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.44)
- Planned Procedure (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.41)
- Planned Supply (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.43)
- Planned Act (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.39)

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 values of profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation

Differential View

This structure is derived from CDAR2.Act

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
classCode |  | 1..1 | code | Required Pattern: ACT
moodCode |  | 1..1 | code | Binding: Planned moodCode (Act/Encounter/Procedure) (required)
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.130
code |  | 1..1 | CD | Binding: Nutrition Recommendations (preferred)
statusCode |  | 1..1 | CS |
code |  | 1..1 | string | Required Pattern: active
effectiveTime |  | 0..1 | IVL_TS | The effectiveTime indicates the time when the activity is intended to take place.
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation
entryRelationship:plannedEncounter |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
encounter |  | 1..1 | PlannedEncounter |
entryRelationship:plannedMedActivity |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
substanceAdministration |  | 1..1 | PlannedMedicationActivity |
entryRelationship:plannedObs |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
observation |  | 1..1 | PlannedObservation |
entryRelationship:plannedProc |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
procedure |  | 1..1 | PlannedProcedure |
entryRelationship:plannedSupply |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
supply |  | 1..1 | PlannedSupply |
entryRelationship:plannedAct |  | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
act |  | 1..1 | PlannedAct |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
classCode |  | 1..1 | code | Required Pattern: ACT
moodCode |  | 1..1 | code | Binding: Planned moodCode (Act/Encounter/Procedure) (required)
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
assigningAuthorityName |  | 0..1 | string |
displayable |  | 0..1 | boolean |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.130
extension |  | 0..1 | string |
id |  | 0..* | II |
code |  | 1..1 | CD | Binding: Nutrition Recommendations (preferred)
negationInd |  | 0..1 | boolean |
text |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: active
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime |  | 0..1 | IVL_TS | The effectiveTime indicates the time when the activity is intended to take place.
priorityCode |  | 0..1 | CE | Binding: ActPriority (extensible)
languageCode |  | 0..1 | CS | Binding: HumanLanguage (required)
subject |  | 0..1 | Element |
typeCode |  | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ
contextControlCode |  | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP
awarenessCode |  | 0..1 | CE | Binding: TargetAwareness (extensible)
relatedSubject |  | 1..1 | RelatedSubject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Element |
typeCode |  | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF
contextControlCode |  | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP
assignedEntity |  | 0..1 | AssignedEntity |
relatedEntity |  | 0..1 | RelatedEntity |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | I | 0..* | Element | Slice: Unordered, Open by profile:act, profile:encounter, profile:substanceAdministration, profile:supply, profile:procedure, profile:observation
entryRelationship:All Slices |  |  |  | Content/Rules for all slices
typeCode |  | 1..1 | code |
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
(Choice of one) |  | 1..1 |  |
observation |  | 0..1 | Observation |
regionOfInterest |  | 0..1 | RegionOfInterest |
observationMedia |  | 0..1 | ObservationMedia |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
procedure |  | 0..1 | Procedure |
encounter |  | 0..1 | Encounter |
organizer |  | 0..1 | Organizer |
act |  | 0..1 | Act |
entryRelationship:plannedEncounter | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
encounter |  | 1..1 | PlannedEncounter |
entryRelationship:plannedMedActivity | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
substanceAdministration |  | 1..1 | PlannedMedicationActivity |
entryRelationship:plannedObs | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
observation |  | 1..1 | PlannedObservation |
entryRelationship:plannedProc | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
procedure |  | 1..1 | PlannedProcedure |
entryRelationship:plannedSupply | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
supply |  | 1..1 | PlannedSupply |
entryRelationship:plannedAct | I | 0..* | Element |
typeCode |  | 1..1 | code | Required Pattern: REFR
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | PlannedAct |
reference |  | 0..* | Element |
typeCode |  | 1..1 | code |
seperatableInd |  | 0..1 | BL |
externalAct |  | 0..1 | ExternalAct |
externalObservation |  | 0..1 | ExternalObservation |
externalProcedure |  | 0..1 | ExternalProcedure |
externalDocument |  | 0..1 | ExternalDocument |
precondition |  | 0..* | Precondition |
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.moodCode | required | Planned moodCode (Act/Encounter/Procedure)
Act.templateId:primary.nullFlavor | required | NullFlavor
Act.code | preferred | Nutrition Recommendations
Act.statusCode | required | ActStatus
Act.statusCode.nullFlavor | required | NullFlavor
Act.priorityCode | extensible | ActPriority
Act.languageCode | required | HumanLanguage
Act.subject.typeCode | required | Fixed Value: SBJ
Act.subject.contextControlCode | required | Fixed Value: OP
Act.subject.awarenessCode | extensible | TargetAwareness
Act.informant.typeCode | required | Fixed Value: INF
Act.informant.contextControlCode | required | Fixed Value: OP

#### Constraints

Id | Grade | Path | Details | Requirements
act-er-1 | error | Act.entryRelationship | Only 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-1 | error | Act.entryRelationship:plannedEncounter | Only 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-1 | error | Act.entryRelationship:plannedMedActivity | Only 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-1 | error | Act.entryRelationship:plannedObs | Only 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-1 | error | Act.entryRelationship:plannedProc | Only 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-1 | error | Act.entryRelationship:plannedSupply | Only 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-1 | error | Act.entryRelationship:plannedAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 |