Consolidated CDA (C-CDA)
4.0.0-ballot - STU4 Ballot United States of America flag

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-ballot 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: CoverageActivity - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the CoverageActivity logical model.

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

0. Act
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-effectiveTime: SHOULD contain effectiveTime (effectiveTime.exists())
2. Act.templateId
Control1..?
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Act.templateId:coverage-activity
    Slice Namecoverage-activity
    Control1..1
    6. Act.templateId:coverage-activity.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.60
    8. Act.templateId:coverage-activity.extension
    Control1..?
    Pattern Value2024-05-01
    10. 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:4537-8872).

    Fixed ValueACT
    12. 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:4537-8873).

    Fixed ValueEVN
    14. Act.id
    Comments

    SHALL contain at least one [1..*] id (CONF:4537-8874).

    Control1..?
    16. Act.code
    ShortDisplay: Payment sources. (USCDI) COVERAGE TYPE: Records the category of health care payers, insurance products, or benefits.
    18. Act.code.code
    Control1..?
    Pattern Value52556-8
    20. Act.code.codeSystem
    ShortLOINC
    Control1..?
    Pattern Value2.16.840.1.113883.6.1
    22. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    24. Act.text.reference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    26. Act.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:4537-8875).

    Control1..?
    28. Act.statusCode.code
    Comments

    This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19094).

    Control1..?
    Fixed Valuecompleted
    30. Act.effectiveTime
    Short𝗨𝗦𝗖𝗗𝗜: COVERAGE STATUS : Records the date and time when you checked and possibly updated the coverage for a patient, and applies for all policies within the coverage activity. Multiple Coverage Activity Acts would be needed to convey different times when coverage was checked and possibly updated. Details on a specific Policy coverage period, or self-pay period, systems can record an additional time inside the Policy Activity/coverage-target participant. Systems may prioritize Coverages using the sequenceNumber.
    Comments

    SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-33064).

    32. Act.effectiveTime.value
    Comments

    The effectiveTime, if present, SHALL contain exactly one [1..1] @value (CONF:4537-33065).

    Control1..?
    34. Act.entryRelationship
    Control1..?
    SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ act
    • value @ typeCode
    • 36. Act.entryRelationship:policy
      Slice Namepolicy
      ShortentryRelationship
      Comments

      SHALL contain at least one [1..*] entryRelationship (CONF:4537-8878) such that it

      Control1..*
      38. Act.entryRelationship:policy.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="COMP" has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:4537-8879).

      Fixed ValueCOMP
      40. Act.entryRelationship:policy.sequenceNumber
      Comments

      MAY contain zero or one [0..1] sequenceNumber (CONF:4537-17174).

      42. Act.entryRelationship:policy.sequenceNumber.value
      Comments

      The sequenceNumber, if present, SHALL contain exactly one [1..1] @value (CONF:4537-17175).

      Control1..?
      44. Act.entryRelationship:policy.act
      Comments

      SHALL contain exactly one [1..1] Policy Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.61:2015-08-01) (CONF:4537-15528).

      Control1..?
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Policy Activity)