Indication - Definitions - Consolidated CDA (C-CDA) v4.0.0-ballot

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: Indication - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the Indication 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`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-effectiveTime: SHOULD contain effectiveTime (`effectiveTime.exists()`) indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (`value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))`)
2. Observation.templateId
Control	1..?
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:indication
Slice Name	indication
Control	1..1
6. Observation.templateId:indication.root
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.22.4.19`
8. Observation.templateId:indication.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:4537-7480).
Fixed Value	`OBS`
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:4537-7481).
Fixed Value	`EVN`
14. Observation.id
Short	If the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.
Comments	SHALL contain at least one [1..*] id (CONF:4537-7483).
Control	1..?
16. Observation.code
Comments	SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1.
Binding	The codes SHOULD be taken from Problem Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1`)
18. Observation.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
20. Observation.text.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('#')`)
22. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).
Control	1..?
24. Observation.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:4537-19105).
Control	1..?
Fixed Value	`completed`
26. Observation.effectiveTime
Comments	SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).
28. Observation.value
Short	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
Comments	MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.
Control	0..1
Binding	The codes SHOULD be taken from US Core Condition Codes (preferred to `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/SC

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-effectiveTime: SHOULD contain effectiveTime (`effectiveTime.exists()`) indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (`value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.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
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
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	1..*
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:indication
Slice Name	indication
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:indication.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:indication.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:indication.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:indication.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	`2.16.840.1.113883.10.20.22.4.19`
30. Observation.templateId:indication.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`
32. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-7480).
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`
34. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-7481).
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`
36. 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.
38. Observation.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short	If the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.Logical id of this artifact
Comments	SHALL contain at least one [1..*] id (CONF:4537-7483). 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
40. Observation.sdtcCategory
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
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`category`.
42. Observation.code
Definition	Describes what was observed. Sometimes this is called the observation "name".
Short	Type of observation (code / type)
Comments	SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1. 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 Problem Type http://hl7.org/fhir/ValueSet/observation-codes (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1`)
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	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ST
46. Observation.text
Definition	A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short	SHOULD reference the portion of section narrative text corresponding to this entryText summary of the resource, for human interpretation
Comments	Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control	0..1 This element is affected by the following invariants: dom-6
Type	http://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
Is Modifier	false
XML Format	The type of this property is determined using the `xsi:type`attribute.
Alternate Names	narrative, html, xhtml, display
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. 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
50. 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
52. 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
54. 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
56. 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
58. 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
60. 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.
62. 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.
64. 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('#')`)
66. 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
68. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).
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
70. 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
72. 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" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19105).
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`
74. 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
76. 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
78. 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
80. 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
82. 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`.
84. 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`.
86. 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
88. 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
90. 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
92. Observation.effectiveTime
Comments	SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
94. 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
96. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
98. 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
100. Observation.value
Short	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
Comments	MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.
Control	0..1
Binding	The codes SHOULD be taken from US Core Condition Codes (preferred to `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
102. 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
104. 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
106. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
108. Observation.subject
Definition	The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
Short	Who and/or what the observation is about
Comments	One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure. This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct)
Is Modifier	false
Requirements	Observations have no value if you don't know who or what they're about.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Observation.specimen
Definition	The specimen that was used when this observation was made.
Short	Specimen used for this observation
Comments	Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
Control	0..*1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SpecimenReference(Specimen, Group)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) obs-9: If Observation.specimen is a reference to Group, the group can only have specimens ((reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen))
112. Observation.performer
Definition	Who was responsible for asserting the observed value as "true".
Short	Who is responsible for the observation
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
Is Modifier	false
Requirements	May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Observation.author
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author
116. Observation.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
118. Observation.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
120. Observation.entryRelationship
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
122. Observation.reference
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
124. Observation.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
126. 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`.
128. Observation.referenceRange
Definition	Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified. Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.
Short	Provides guide for interpretation
Comments	Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRootBackboneElement
Is Modifier	false
Requirements	Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
130. 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
132. 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
134. 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
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
136. 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
138. 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
140. 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
142. 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`
144. 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
146. 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
148. 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`
150. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
152. 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`.

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-effectiveTime: SHOULD contain effectiveTime (`effectiveTime.exists()`) indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. (`value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.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
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
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	1..*
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:indication
Slice Name	indication
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:indication.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:indication.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:indication.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:indication.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	`2.16.840.1.113883.10.20.22.4.19`
30. Observation.templateId:indication.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`
32. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4537-7480).
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`
34. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4537-7481).
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`
36. 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.
38. Observation.id
Short	If the id element is used to reference a problem recorded elsewhere in the document then this id must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. Its purpose is to obviate the need to repeat the complete XML representation of the referred to entry when relating one entry to another.
Comments	SHALL contain at least one [1..*] id (CONF:4537-7483).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
40. Observation.sdtcCategory
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
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`category`.
42. Observation.code
Comments	SHALL contain exactly one [1..1] code, which MAY be selected from ValueSet Problem Type urn:oid:2.16.840.1.113762.1.4.1267.1.
Control	1..1
Binding	The codes SHOULD be taken from Problem Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.1`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
44. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ST
46. 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.
48. 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
50. 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
52. 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
54. 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
56. 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
58. 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
60. 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.
62. 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.
64. 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('#')`)
66. 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
68. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4537-7487).
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
70. 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
72. 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" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4537-19105).
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`
74. 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
76. 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
78. 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
80. 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
82. 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`.
84. 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`.
86. 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
88. 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
90. 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
92. Observation.effectiveTime
Comments	SHOULD contain zero or one [0..1] effectiveTime (CONF:4537-7488).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
94. 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
96. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
98. 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
100. Observation.value
Short	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
Comments	MAY contain zero or one [0..1] value with @xsi:type="CD", where the code MAY be selected from ValueSet US Core Condition Codes.
Control	0..1
Binding	The codes SHOULD be taken from US Core Condition Codes (preferred to `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
102. 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
104. 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
106. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
108. Observation.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
110. Observation.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
112. Observation.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
114. Observation.author
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author
116. Observation.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
118. Observation.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
120. Observation.entryRelationship
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
122. Observation.reference
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
124. Observation.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
126. 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`.
128. 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
130. 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
132. 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
134. 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
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
136. 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
138. 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
140. 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
142. 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`
144. 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
146. 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
148. 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`
150. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
152. 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`.