Gender Identity Observation - Definitions - Consolidated CDA (C-CDA) v4.0.0

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: GenderIdentityObservation - Detailed Descriptions

Draft as of 2024-10-19

Definitions for the GenderIdentityObservation logical model.

Differential Elements Table
Key Elements Table
Snapshot Elements Table

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

0. Observation
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
2. Observation.templateId
Control	2..?
4. Observation.templateId:gender-identity-obs
Slice Name	gender-identity-obs
Control	1..1
6. Observation.templateId:gender-identity-obs.root
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.34.3.45`
8. Observation.templateId:gender-identity-obs.extension
Control	1..?
Pattern Value	`2023-05-01`
10. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-1230).
12. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-1231).
14. Observation.code
Short	Gender Identity
Comments	SHALL contain exactly one [1..1] code (CONF:4537-1222).
16. Observation.code.code
Comments	This code SHALL contain exactly one [1..1] @code="76691-5" Gender identity (CONF:4537-1227).
Control	1..?
Pattern Value	`76691-5`
18. Observation.code.codeSystem
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1 STATIC) (CONF:4537-1228).
Control	1..?
Pattern Value	`2.16.840.1.113883.6.1`
20. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-33067).
22. Observation.statusCode.code
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:4537-33069).
24. Observation.effectiveTime
Short	The effectiveTime represents the relevant time of the observation. A patient's "gender identity" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified as specified.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:4537-33068).
26. Observation.effectiveTime.low
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:4537-33070).
Control	1..?
28. Observation.effectiveTime.high
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:4537-33071).
30. Observation.value
Control	1..?
32. Observation.value:physical-quantity
Slice Name	physical-quantity
Control	0..0
34. Observation.value:coded
Slice Name	coded
Comments	SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from ValueSet Gender Identity urn:oid:2.16.840.1.113762.1.4.1021.32 DYNAMIC.
Control	1..?
Binding	The codes SHALL be taken from Gender Identity (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.32`)

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

0. Observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type. Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Control	10..1*
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-value: SHOULD contain value (`value.exists()`) 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. () should-sh-author: SHOULD contain author (`author.exists()`)
2. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	2..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root value @ extension
4. Observation.templateId:social-history-obs
Slice Name	social-history-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
6. Observation.templateId:social-history-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.38`
8. Observation.templateId:social-history-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2022-06-01`
10. Observation.templateId:gender-identity-obs
Slice Name	gender-identity-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
12. Observation.templateId:gender-identity-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.34.3.45`
14. Observation.templateId:gender-identity-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2023-05-01`
16. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-1230).
Control	1..1
Binding	The codes SHALL be taken from CDAActClassObservation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OBS`
18. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-1231).
Control	1..1
Binding	The codes SHALL be taken from XActMoodDocumentObservation (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
20. Observation.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short	Logical id of this artifact
Comments	SHALL contain at least one [1..*] id (CONF:4515-8551). Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Control	10..*1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IIid
Is Modifier	false
22. Observation.code
Definition	Describes what was observed. Sometimes this is called the observation "name".
Short	Gender IdentityType of observation (code / type)
Comments	SHALL contain exactly one [1..1] code (CONF:4537-1222). All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control	1..1 This element is affected by the following invariants: obs-7
Binding	The codes SHOULD be taken from For example codes, see Social History Type http://hl7.org/fhir/ValueSet/observation-codes (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
Is Modifier	false
XML Format	The type of this property is determined using the `xsi:type`attribute.
Requirements	Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names	Name
Invariants	4515-32956: If @codeSystem is not LOINC, then this code SHALL contain at least one [1..] translation, which SHOULD* be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). (`codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Observation.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This code SHALL contain exactly one [1..1] @code="76691-5" Gender identity (CONF:4537-1227).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`76691-5`
26. Observation.code.codeSystem
Definition	Specifies the code system that defines the code.
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1 STATIC) (CONF:4537-1228).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
28. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-33067).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
30. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:4537-33069).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Fixed Value	`completed`
32. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
34. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
36. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
38. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
40. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
42. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
44. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
46. Observation.effectiveTime
Short	The effectiveTime represents the relevant time of the observation. A patient's "gender identity" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified as specified.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:4537-33068).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
48. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:4537-33070).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
50. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:4537-33071).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
52. Observation.value
Short	(USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns
Comments	SHOULD contain zero or one [0..1] value (CONF:4515-8559).
Control	1..1
Type	Choice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
Slicing	This element introduces a set of slices on `Observation.value`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
54. Observation.value:physical-quantity
Slice Name	physical-quantity
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
57. Observation.value:coded
Slice Name	coded
Comments	SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from ValueSet Gender Identity urn:oid:2.16.840.1.113762.1.4.1021.32 DYNAMIC.
Control	1..1
Binding	The codes SHALL be taken from Gender Identity (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.32`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
59. Observation.entryRelationship
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-32969) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Observation.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ act profile @ observation
61. Observation.entryRelationship:supportingObs
Slice Name	supportingObs
Short	When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-32958) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
63. Observation.entryRelationship:supportingObs.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32960).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`SPRT`
65. Observation.entryRelationship:supportingObs.observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Assessment Scale Observation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.69) (CONF:4515-32959).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Assessment Scale Observation)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
67. Observation.entryRelationship:entryReference
Slice Name	entryReference
Short	When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference MAY reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
69. Observation.entryRelationship:entryReference.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32971).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`SPRT`
71. Observation.entryRelationship:entryReference.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32970).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)

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

0. Observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-value: SHOULD contain value (`value.exists()`) 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. () should-sh-author: SHOULD contain author (`author.exists()`)
2. Observation.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Observation.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
6. Observation.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
8. Observation.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
10. Observation.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
12. Observation.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Observation.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Observation.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
18. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	2..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root value @ extension
20. Observation.templateId:social-history-obs
Slice Name	social-history-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Observation.templateId:social-history-obs.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Observation.templateId:social-history-obs.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Observation.templateId:social-history-obs.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Observation.templateId:social-history-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.38`
30. Observation.templateId:social-history-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2022-06-01`
32. Observation.templateId:gender-identity-obs
Slice Name	gender-identity-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
34. Observation.templateId:gender-identity-obs.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
36. Observation.templateId:gender-identity-obs.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
38. Observation.templateId:gender-identity-obs.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
40. Observation.templateId:gender-identity-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.34.3.45`
42. Observation.templateId:gender-identity-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2023-05-01`
44. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-1230).
Control	1..1
Binding	The codes SHALL be taken from CDAActClassObservation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OBS`
46. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-1231).
Control	1..1
Binding	The codes SHALL be taken from XActMoodDocumentObservation (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
48. Observation.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
50. Observation.id
Comments	SHALL contain at least one [1..*] id (CONF:4515-8551).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
52. Observation.code
Short	Gender Identity
Comments	SHALL contain exactly one [1..1] code (CONF:4537-1222).
Control	1..1
Binding	The codes SHOULD be taken from Social History Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Invariants	4515-32956: If @codeSystem is not LOINC, then this code SHALL contain at least one [1..] translation, which SHOULD* be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). (`codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists()`)
54. Observation.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
56. Observation.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This code SHALL contain exactly one [1..1] @code="76691-5" Gender identity (CONF:4537-1227).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`76691-5`
58. Observation.code.codeSystem
Definition	Specifies the code system that defines the code.
Comments	This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1 STATIC) (CONF:4537-1228).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
60. Observation.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
62. Observation.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
64. Observation.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
66. Observation.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
68. Observation.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
70. Observation.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
72. Observation.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
74. Observation.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
76. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ST
78. Observation.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
XML Format	The type of this property is determined using the `xsi:type`attribute.
80. Observation.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
82. Observation.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
84. Observation.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
86. Observation.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
88. Observation.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
90. Observation.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
92. Observation.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
94. Observation.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
96. Observation.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
98. Observation.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
100. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-33067).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
102. Observation.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
104. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:4537-33069).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Fixed Value	`completed`
106. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
108. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
110. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
112. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
114. Observation.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
116. Observation.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
118. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
120. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
122. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
124. Observation.effectiveTime
Short	The effectiveTime represents the relevant time of the observation. A patient's "gender identity" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified as specified.
Comments	SHALL contain exactly one [1..1] effectiveTime (CONF:4537-33068).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
126. Observation.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
128. Observation.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
130. Observation.effectiveTime.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
132. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] low (CONF:4537-33070).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
134. Observation.effectiveTime.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
136. Observation.effectiveTime.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
138. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Comments	This effectiveTime MAY contain zero or one [0..1] high (CONF:4537-33071).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
140. Observation.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
142. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
144. Observation.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
146. Observation.value
Short	(USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns
Comments	SHOULD contain zero or one [0..1] value (CONF:4515-8559).
Control	1..1
Type	Choice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
Slicing	This element introduces a set of slices on `Observation.value`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
148. Observation.value:physical-quantity
Slice Name	physical-quantity
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
154. Observation.value:coded
Slice Name	coded
Comments	SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from ValueSet Gender Identity urn:oid:2.16.840.1.113762.1.4.1021.32 DYNAMIC.
Control	1..1
Binding	The codes SHALL be taken from Gender Identity (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.32`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
156. Observation.interpretationCode
Control	0..*
Binding	The codes SHALL be taken from CDAObservationInterpretation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
158. Observation.methodCode
Control	0..*
Binding	For example codes, see ObservationMethod (example to `http://terminology.hl7.org/ValueSet/v3-ObservationMethod`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
160. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
162. Observation.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
164. Observation.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
166. Observation.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
168. Observation.author
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31869).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
170. Observation.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
172. Observation.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
174. Observation.entryRelationship
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-32969) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Observation.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ act profile @ observation
176. Observation.entryRelationship:supportingObs
Slice Name	supportingObs
Short	When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-32958) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
178. Observation.entryRelationship:supportingObs.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
180. Observation.entryRelationship:supportingObs.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
182. Observation.entryRelationship:supportingObs.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
184. Observation.entryRelationship:supportingObs.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
186. Observation.entryRelationship:supportingObs.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
188. Observation.entryRelationship:supportingObs.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
190. Observation.entryRelationship:supportingObs.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
192. Observation.entryRelationship:supportingObs.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
194. Observation.entryRelationship:supportingObs.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
196. Observation.entryRelationship:supportingObs.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32960).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`SPRT`
198. Observation.entryRelationship:supportingObs.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
200. Observation.entryRelationship:supportingObs.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
202. Observation.entryRelationship:supportingObs.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
204. Observation.entryRelationship:supportingObs.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
206. Observation.entryRelationship:supportingObs.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
208. Observation.entryRelationship:supportingObs.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
210. Observation.entryRelationship:supportingObs.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
212. Observation.entryRelationship:supportingObs.observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Assessment Scale Observation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.69) (CONF:4515-32959).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Assessment Scale Observation)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
214. Observation.entryRelationship:supportingObs.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
216. Observation.entryRelationship:supportingObs.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
218. Observation.entryRelationship:supportingObs.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
220. Observation.entryRelationship:supportingObs.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
222. Observation.entryRelationship:supportingObs.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
224. Observation.entryRelationship:supportingObs.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
226. Observation.entryRelationship:entryReference
Slice Name	entryReference
Short	When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference MAY reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
228. Observation.entryRelationship:entryReference.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
230. Observation.entryRelationship:entryReference.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
232. Observation.entryRelationship:entryReference.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
234. Observation.entryRelationship:entryReference.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
236. Observation.entryRelationship:entryReference.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
238. Observation.entryRelationship:entryReference.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
240. Observation.entryRelationship:entryReference.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
242. Observation.entryRelationship:entryReference.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
244. Observation.entryRelationship:entryReference.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
246. Observation.entryRelationship:entryReference.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32971).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`SPRT`
248. Observation.entryRelationship:entryReference.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
250. Observation.entryRelationship:entryReference.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
252. Observation.entryRelationship:entryReference.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
254. Observation.entryRelationship:entryReference.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
256. Observation.entryRelationship:entryReference.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
258. Observation.entryRelationship:entryReference.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32970).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
260. Observation.entryRelationship:entryReference.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
262. Observation.entryRelationship:entryReference.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
264. Observation.entryRelationship:entryReference.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
266. Observation.entryRelationship:entryReference.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
268. Observation.entryRelationship:entryReference.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
270. Observation.entryRelationship:entryReference.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
272. Observation.entryRelationship:entryReference.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
274. Observation.entryRelationship:entryReference.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
276. Observation.reference
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
278. Observation.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
280. Observation.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
282. Observation.referenceRange
Definition	Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
284. Observation.referenceRange.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
286. Observation.referenceRange.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
288. Observation.referenceRange.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
290. Observation.referenceRange.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
292. Observation.referenceRange.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
294. Observation.referenceRange.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
296. Observation.referenceRange.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
298. Observation.referenceRange.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
300. Observation.referenceRange.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
302. Observation.referenceRange.typeCode
Control	0..1
Binding	The codes SHALL be taken from CDAActRelationshipType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFV`
304. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
306. Observation.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.