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: Allergy Concern Act

Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.30 | Version: 2.2
Active as of 2022-05-13 | Computable Name: AllergyConcernAct
Other Identifiers: : urn:hl7ii:2.16.840.1.113883.10.20.22.4.30:2015-08-01

This template reflects an ongoing concern on behalf of the provider that placed the allergy on a patients allergy list. As long as the underlying condition is of concern to the provider (i.e., as long as the allergy, whether active or resolved, is of ongoing concern and interest to the provider), the statusCode is active. Only when the underlying allergy is no longer of concern is the statusCode set to completed. The effectiveTime reflects the time that the underlying allergy was felt to be a concern.

The statusCode of the Allergy Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Allergy - Intolerance Observation is the definitive indication of whether or not the underlying allergy is resolved.

The effectiveTime/low of the Allergy Concern Act asserts when the concern became active. This equates to the time the concern was authored in the patient’s chart. 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).

Usage:

- Use this Resource Profile: Allergies and Intolerances Section (entries required), Allergies and Intolerances Section (entries optional)

### 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: 15 elements

Structures

This structure refers to these other structures:

- Author Participation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.119)
- Allergy - Intolerance Observation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.7)

Slices

This structure defines the following Slices:

- The element Act.templateId is sliced based on the values of value:extension, value:root
- The element Act.entryRelationship is sliced based on the value of 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 | Required Pattern: EVN
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:extension, value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.30
extension |  | 1..1 | string | Required Pattern: 2015-08-01
id |  | 1..* | II |
code |  | 1..1 | CD |
code |  | 1..1 | string | Required Pattern: CONC
codeSystem |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6
statusCode |  | 1..1 | CS |
code |  | 1..1 | string | Binding: https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19 (required)
effectiveTime | I | 1..1 | IVL_TS | 1198-10085: If statusCode/@code="completed" Completed, then effectiveTime **SHALL** contain [1..1] high (CONF:1198-10085). 1198-7504: If statusCode/@code="active" Active, then effectiveTime **SHALL** contain [1..1] low (CONF:1198-7504).
author |  | 0..* | AuthorParticipation |
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:observation
entryRelationship:allergyObs |  | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: SUBJ
observation |  | 1..1 | AllergyIntoleranceObservation |
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 | Required Pattern: EVN
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:extension, 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: 2.16.840.1.113883.10.20.22.4.30
extension |  | 1..1 | string | Required Pattern: 2015-08-01
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: CONC
codeSystem |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6
codeSystemName |  | 0..1 | string |
codeSystemVersion |  | 0..1 | string |
displayName |  | 0..1 | string |
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
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 | Binding: https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19 (required)
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | I | 1..1 | IVL_TS | 1198-10085: If statusCode/@code="completed" Completed, then effectiveTime **SHALL** contain [1..1] high (CONF:1198-10085). 1198-7504: If statusCode/@code="active" Active, then effectiveTime **SHALL** contain [1..1] low (CONF:1198-7504).
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..* | AuthorParticipation |
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: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:allergyObs | I | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: SUBJ
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
observation |  | 1..1 | AllergyIntoleranceObservation |
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: 15 elements

Structures

This structure refers to these other structures:

- Author Participation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.119)
- Allergy - Intolerance Observation (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.7)

Slices

This structure defines the following Slices:

- The element Act.templateId is sliced based on the values of value:extension, value:root
- The element Act.entryRelationship is sliced based on the value of 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 | Required Pattern: EVN
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:extension, value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.30
extension |  | 1..1 | string | Required Pattern: 2015-08-01
id |  | 1..* | II |
code |  | 1..1 | CD |
code |  | 1..1 | string | Required Pattern: CONC
codeSystem |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6
statusCode |  | 1..1 | CS |
code |  | 1..1 | string | Binding: https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19 (required)
effectiveTime | I | 1..1 | IVL_TS | 1198-10085: If statusCode/@code="completed" Completed, then effectiveTime **SHALL** contain [1..1] high (CONF:1198-10085). 1198-7504: If statusCode/@code="active" Active, then effectiveTime **SHALL** contain [1..1] low (CONF:1198-7504).
author |  | 0..* | AuthorParticipation |
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:observation
entryRelationship:allergyObs |  | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: SUBJ
observation |  | 1..1 | AllergyIntoleranceObservation |
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 | Required Pattern: EVN
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 0..* | II | Slice: Unordered, Open by value:extension, 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: 2.16.840.1.113883.10.20.22.4.30
extension |  | 1..1 | string | Required Pattern: 2015-08-01
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: CONC
codeSystem |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6
codeSystemName |  | 0..1 | string |
codeSystemVersion |  | 0..1 | string |
displayName |  | 0..1 | string |
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
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 | Binding: https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19 (required)
sdtcValueSet |  | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion |  | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | I | 1..1 | IVL_TS | 1198-10085: If statusCode/@code="completed" Completed, then effectiveTime **SHALL** contain [1..1] high (CONF:1198-10085). 1198-7504: If statusCode/@code="active" Active, then effectiveTime **SHALL** contain [1..1] low (CONF:1198-7504).
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..* | AuthorParticipation |
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: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:allergyObs | I | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: SUBJ
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
observation |  | 1..1 | AllergyIntoleranceObservation |
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.templateId:primary.nullFlavor | required | NullFlavor
Act.code | extensible | ActCode
Act.code.nullFlavor | required | NullFlavor
Act.statusCode | required | ActStatus
Act.statusCode.nullFlavor | required | NullFlavor
Act.statusCode.code | required | https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19
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
1198-10085 | error | Act.effectiveTime | If statusCode/@code="completed" Completed, then effectiveTime **SHALL** contain [1..1] high (CONF:1198-10085). : |
1198-7504 | error | Act.effectiveTime | If statusCode/@code="active" Active, then effectiveTime **SHALL** contain [1..1] low (CONF:1198-7504). : |
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:allergyObs | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 |