Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions
Logical Model:
Authorization Activity
Official URL : http://hl7.org/cda/us/ccda/StructureDefinition/AuthorizationActivity
Version :
4.0.0
Draft
as of 2025-10-02
Computable Name : AuthorizationActivity
Other Identifiers: OID:2.16.840.1.113883.10.20.1.19
An Authorization Activity represents authorizations or pre-authorizations currently active for the patient for the particular payer.
Authorizations are represented using an act subordinate to the policy or program that provided it. The authorization refers to the policy or program. Authorized treatments can be grouped into an organizer class, where common properties, such as the reason for the authorization, can be expressed. Subordinate acts represent what was authorized.
Usages:
You can also check for usages in the FHIR IG Statistics
Changes since version 3.0.0:
New Content
Formal Views of Template Content
Description of Template, Differentials, Snapshots and how the different presentations work .
This structure is derived from Act
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
Name Flags Card. Type Description & Constraints Filter: Bindings Constraints Obligations
Act
C
1..1
Act
XML Namespace: urn:hl7-org:v3 Base for all types and resourcesInstance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
Slices for templateId
1 .. *
II
Slice: Unordered, Open by value:root
templateId:authorization-activity
1..1
II
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Required Pattern: 2.16.840.1.113883.10.20.1.19
@classCode
1..1
cs
Binding: XActClassDocumentEntryAct (2.0.0) ( required ) Fixed Value: ACT
@moodCode
1..1
cs
Binding: XDocumentActMood (2.0.0) ( required ) Fixed Value: EVN
@negationInd
0..1
bl
id
1..1
II
code
1..1
CD
Binding: v3 Code System ActCode ( example )
text
0..1
ED
SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@compression
0..1
cs
Binding: CDACompressionAlgorithm ( required )
@integrityCheck
0..1
bin
@integrityCheckAlgorithm
0..1
cs
Binding: IntegrityCheckAlgorithm (2.0.0) ( required )
@language
0..1
cs
@mediaType
0..1
cs
Binding: MediaType ( example )
@representation
0..1
cs
Binding: CDABinaryDataEncoding ( required )
xmlText
0..1
st
Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference
C
0..1
TEL
Constraints: value-starts-octothorpe
thumbnail
0..1
ED
statusCode
0..1
CS
Binding: ActStatus ( required )
effectiveTime
0..1
IVL_TS
priorityCode
0..1
CE
Binding: ActPriority ( example )
languageCode
0..1
CS
Binding: AllLanguages ( required )
subject
0..1
Subject
specimen
0..*
Specimen
performer
0..*
Performer2
author
0..*
Author
informant
0..*
Informant
participant
0..*
Participant2
Slices for entryRelationship
1 .. *
EntryRelationship
Slice: Unordered, Open by value:typeCode
entryRelationship:target
C
1..*
EntryRelationship
The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).Constraints: 81-8951
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
templateId
0..*
II
@typeCode
1..1
cs
Binding: x_ActRelationshipEntryRelationship ( required ) Fixed Value: SUBJ
@inversionInd
0..1
bl
@contextConductionInd
0..1
bl
@negationInd
0..1
bl
sequenceNumber
0..1
INT
seperatableInd
0..1
BL
act
0..1
Act
encounter
0..1
Encounter
observation
0..1
Observation
observationMedia
0..1
ObservationMedia
organizer
0..1
Organizer
procedure
0..1
Procedure
regionOfInterest
0..1
RegionOfInterest
substanceAdministration
0..1
SubstanceAdministration
supply
0..1
Supply
reference
0..*
Reference
precondition
0..*
Precondition
sdtcPrecondition2
0..*
Precondition2
XML Namespace: urn:hl7-org:sdtcXML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1
0..*
InFulfillmentOf1
XML Namespace: urn:hl7-org:sdtcXML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format
Terminology Bindings
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1
error
Act.typeId, Act.entryRelationship:target.typeId
An II instance must have either a root or an nullFlavor.
root.exists() or nullFlavor.exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
Name Flags Card. Type Description & Constraints Filter: Bindings Constraints Obligations
Act
C
1..1
Act
XML Namespace: urn:hl7-org:v3 Base for all types and resourcesInstance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
Slices for templateId
1 .. *
II
Slice: Unordered, Open by value:root
templateId:authorization-activity
1..1
II
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Required Pattern: 2.16.840.1.113883.10.20.1.19
@classCode
1..1
cs
Binding: XActClassDocumentEntryAct (2.0.0) ( required ) Fixed Value: ACT
@moodCode
1..1
cs
Binding: XDocumentActMood (2.0.0) ( required ) Fixed Value: EVN
@negationInd
0..1
bl
id
1..1
II
code
1..1
CD
Binding: v3 Code System ActCode ( example )
text
0..1
ED
SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@compression
0..1
cs
Binding: CDACompressionAlgorithm ( required )
@integrityCheck
0..1
bin
@integrityCheckAlgorithm
0..1
cs
Binding: IntegrityCheckAlgorithm (2.0.0) ( required )
@language
0..1
cs
@mediaType
0..1
cs
Binding: MediaType ( example )
@representation
0..1
cs
Binding: CDABinaryDataEncoding ( required )
xmlText
0..1
st
Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference
C
0..1
TEL
Constraints: value-starts-octothorpe
thumbnail
0..1
ED
statusCode
0..1
CS
Binding: ActStatus ( required )
effectiveTime
0..1
IVL_TS
priorityCode
0..1
CE
Binding: ActPriority ( example )
languageCode
0..1
CS
Binding: AllLanguages ( required )
subject
0..1
Subject
specimen
0..*
Specimen
performer
0..*
Performer2
author
0..*
Author
informant
0..*
Informant
participant
0..*
Participant2
Slices for entryRelationship
1 .. *
EntryRelationship
Slice: Unordered, Open by value:typeCode
entryRelationship:target
C
1..*
EntryRelationship
The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).Constraints: 81-8951
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
templateId
0..*
II
@typeCode
1..1
cs
Binding: x_ActRelationshipEntryRelationship ( required ) Fixed Value: SUBJ
@inversionInd
0..1
bl
@contextConductionInd
0..1
bl
@negationInd
0..1
bl
sequenceNumber
0..1
INT
seperatableInd
0..1
BL
act
0..1
Act
encounter
0..1
Encounter
observation
0..1
Observation
observationMedia
0..1
ObservationMedia
organizer
0..1
Organizer
procedure
0..1
Procedure
regionOfInterest
0..1
RegionOfInterest
substanceAdministration
0..1
SubstanceAdministration
supply
0..1
Supply
reference
0..*
Reference
precondition
0..*
Precondition
sdtcPrecondition2
0..*
Precondition2
XML Namespace: urn:hl7-org:sdtcXML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1
0..*
InFulfillmentOf1
XML Namespace: urn:hl7-org:sdtcXML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format
Terminology Bindings
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1
error
Act.typeId, Act.entryRelationship:target.typeId
An II instance must have either a root or an nullFlavor.
root.exists() or nullFlavor.exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
This structure is derived from Act
Summary
Mandatory: 6 elements Fixed: 3 elements Prohibited: 1 element
Slices
This structure defines the following Slices :
The element 1 is sliced based on the value of Act.templateId
The element 1 is sliced based on the value of Act.entryRelationship
Differential View
This structure is derived from Act
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
Key Elements View
Name Flags Card. Type Description & Constraints Filter: Bindings Constraints Obligations
Act
C
1..1
Act
XML Namespace: urn:hl7-org:v3 Base for all types and resourcesInstance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
Slices for templateId
1 .. *
II
Slice: Unordered, Open by value:root
templateId:authorization-activity
1..1
II
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Required Pattern: 2.16.840.1.113883.10.20.1.19
@classCode
1..1
cs
Binding: XActClassDocumentEntryAct (2.0.0) ( required ) Fixed Value: ACT
@moodCode
1..1
cs
Binding: XDocumentActMood (2.0.0) ( required ) Fixed Value: EVN
@negationInd
0..1
bl
id
1..1
II
code
1..1
CD
Binding: v3 Code System ActCode ( example )
text
0..1
ED
SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@compression
0..1
cs
Binding: CDACompressionAlgorithm ( required )
@integrityCheck
0..1
bin
@integrityCheckAlgorithm
0..1
cs
Binding: IntegrityCheckAlgorithm (2.0.0) ( required )
@language
0..1
cs
@mediaType
0..1
cs
Binding: MediaType ( example )
@representation
0..1
cs
Binding: CDABinaryDataEncoding ( required )
xmlText
0..1
st
Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference
C
0..1
TEL
Constraints: value-starts-octothorpe
thumbnail
0..1
ED
statusCode
0..1
CS
Binding: ActStatus ( required )
effectiveTime
0..1
IVL_TS
priorityCode
0..1
CE
Binding: ActPriority ( example )
languageCode
0..1
CS
Binding: AllLanguages ( required )
subject
0..1
Subject
specimen
0..*
Specimen
performer
0..*
Performer2
author
0..*
Author
informant
0..*
Informant
participant
0..*
Participant2
Slices for entryRelationship
1 .. *
EntryRelationship
Slice: Unordered, Open by value:typeCode
entryRelationship:target
C
1..*
EntryRelationship
The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).Constraints: 81-8951
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
templateId
0..*
II
@typeCode
1..1
cs
Binding: x_ActRelationshipEntryRelationship ( required ) Fixed Value: SUBJ
@inversionInd
0..1
bl
@contextConductionInd
0..1
bl
@negationInd
0..1
bl
sequenceNumber
0..1
INT
seperatableInd
0..1
BL
act
0..1
Act
encounter
0..1
Encounter
observation
0..1
Observation
observationMedia
0..1
ObservationMedia
organizer
0..1
Organizer
procedure
0..1
Procedure
regionOfInterest
0..1
RegionOfInterest
substanceAdministration
0..1
SubstanceAdministration
supply
0..1
Supply
reference
0..*
Reference
precondition
0..*
Precondition
sdtcPrecondition2
0..*
Precondition2
XML Namespace: urn:hl7-org:sdtcXML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1
0..*
InFulfillmentOf1
XML Namespace: urn:hl7-org:sdtcXML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format
Terminology Bindings
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1
error
Act.typeId, Act.entryRelationship:target.typeId
An II instance must have either a root or an nullFlavor.
root.exists() or nullFlavor.exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
Snapshot View
Name Flags Card. Type Description & Constraints Filter: Bindings Constraints Obligations
Act
C
1..1
Act
XML Namespace: urn:hl7-org:v3 Base for all types and resourcesInstance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
Slices for templateId
1 .. *
II
Slice: Unordered, Open by value:root
templateId:authorization-activity
1..1
II
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Required Pattern: 2.16.840.1.113883.10.20.1.19
@classCode
1..1
cs
Binding: XActClassDocumentEntryAct (2.0.0) ( required ) Fixed Value: ACT
@moodCode
1..1
cs
Binding: XDocumentActMood (2.0.0) ( required ) Fixed Value: EVN
@negationInd
0..1
bl
id
1..1
II
code
1..1
CD
Binding: v3 Code System ActCode ( example )
text
0..1
ED
SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@compression
0..1
cs
Binding: CDACompressionAlgorithm ( required )
@integrityCheck
0..1
bin
@integrityCheckAlgorithm
0..1
cs
Binding: IntegrityCheckAlgorithm (2.0.0) ( required )
@language
0..1
cs
@mediaType
0..1
cs
Binding: MediaType ( example )
@representation
0..1
cs
Binding: CDABinaryDataEncoding ( required )
xmlText
0..1
st
Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference
C
0..1
TEL
Constraints: value-starts-octothorpe
thumbnail
0..1
ED
statusCode
0..1
CS
Binding: ActStatus ( required )
effectiveTime
0..1
IVL_TS
priorityCode
0..1
CE
Binding: ActPriority ( example )
languageCode
0..1
CS
Binding: AllLanguages ( required )
subject
0..1
Subject
specimen
0..*
Specimen
performer
0..*
Performer2
author
0..*
Author
informant
0..*
Informant
participant
0..*
Participant2
Slices for entryRelationship
1 .. *
EntryRelationship
Slice: Unordered, Open by value:typeCode
entryRelationship:target
C
1..*
EntryRelationship
The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).Constraints: 81-8951
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
realmCode
0..*
CS
typeId
C
0..1
II
Constraints: II-1
@nullFlavor
0..1
cs
Binding: CDANullFlavor ( required )
@assigningAuthorityName
0..1
st
@displayable
0..1
bl
@root
1..1
oid , uuid , ruid
Fixed Value: 2.16.840.1.113883.1.3
@extension
1..1
st
templateId
0..*
II
@typeCode
1..1
cs
Binding: x_ActRelationshipEntryRelationship ( required ) Fixed Value: SUBJ
@inversionInd
0..1
bl
@contextConductionInd
0..1
bl
@negationInd
0..1
bl
sequenceNumber
0..1
INT
seperatableInd
0..1
BL
act
0..1
Act
encounter
0..1
Encounter
observation
0..1
Observation
observationMedia
0..1
ObservationMedia
organizer
0..1
Organizer
procedure
0..1
Procedure
regionOfInterest
0..1
RegionOfInterest
substanceAdministration
0..1
SubstanceAdministration
supply
0..1
Supply
reference
0..*
Reference
precondition
0..*
Precondition
sdtcPrecondition2
0..*
Precondition2
XML Namespace: urn:hl7-org:sdtcXML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1
0..*
InFulfillmentOf1
XML Namespace: urn:hl7-org:sdtcXML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format
Terminology Bindings
Constraints
Id
Grade
Path(s)
Description
Expression
81-8951
error
Act.entryRelationship:target
The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951).
(act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
II-1
error
Act.typeId, Act.entryRelationship:target.typeId
An II instance must have either a root or an nullFlavor.
root.exists() or nullFlavor.exists()
should-text-ref-value
warning
Act
SHOULD contain text/reference/@value
text.reference.value.exists()
value-starts-octothorpe
error
Act.text.reference
If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
value.exists() implies value.startsWith('#')
This structure is derived from Act
Summary
Mandatory: 6 elements Fixed: 3 elements Prohibited: 1 element
Slices
This structure defines the following Slices :
The element 1 is sliced based on the value of Act.templateId
The element 1 is sliced based on the value of Act.entryRelationship
Other representations of profile: CSV , Excel