Consolidated CDA (C-CDA)
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Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 5.0.0-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: NoteActivity - Detailed Descriptions

Draft as of 2025-12-02

Definitions for the NoteActivity logical model.

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

0. 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.


Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
2. Act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Act.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

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.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.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
8. Act.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
10. Act.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.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
12. Act.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).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
14. Act.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
16. Act.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
18. Act.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

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 20. Act.templateId:note-activity
    Slice Namenote-activity
    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

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    22. Act.templateId:note-activity.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    24. Act.templateId:note-activity.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.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    26. Act.templateId:note-activity.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    28. Act.templateId:note-activity.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.10.20.22.4.202
    30. Act.templateId:note-activity.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control1..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    Pattern Value2026-05-01
    32. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

    Control1..1
    BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueACT
    34. Act.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

    Control1..1
    BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueEVN
    36. Act.negationInd
    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    38. Act.id
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    40. Act.code
    Control1..1
    BindingThe codes SHALL be taken from US Core DocumentReference Type
    (required to http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    42. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    Comments

    SHALL contain exactly one [1..1] text (CONF:3250-16896).

    Control1..1
    This element is affected by the following invariants: should-text-ref-value
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (mediaType.exists() implies (representation = 'B64' and xmlText.exists()))
    44. Act.text.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    46. Act.text.compression
    Definition

    Indicates whether the raw byte data is compressed, and what compression algorithm was used.

    Control0..1
    BindingThe codes SHALL be taken from CDACompressionAlgorithm
    (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCompression
    48. Act.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.

    Control0..1
    Typebase64Binary(bin: Binary Data)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check
    50. Act.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.

    Control0..1
    BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check Algorithm
    52. Act.text.language
    Definition

    For character based information the language property specifies the human language of the text.

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelLanguage
    54. Act.text.mediaType
    Definition

    Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

    ShortIf the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
    Comments

    This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

    Control0..1
    BindingThe codes SHOULD be taken from SupportedFileFormats .
    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelMedia Type
    56. Act.text.representation
    Control0..1
    BindingThe codes SHALL be taken from CDABinaryDataEncoding
    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    58. Act.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.)

    ShortAllows 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.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as unadorned text.
    60. Act.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.

    Comments

    This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    LabelReference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    62. Act.text.reference.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    ShortThe note activity must reference human-readable content in the narrative, so this reference must not be null.
    Comments

    This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

    Control0..0
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    64. Act.text.reference.value
    Comments

    This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

    Control1..1
    Typeurl(url: Universal Resource Locator)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    66. Act.text.reference.useablePeriod
    Definition

    Specifies the periods of time during which the telecommunication address can be used. For a telephone number, this can indicate the time of day in which the party can be reached on that telephone. For a web address, it may specify a time range in which the web content is promised to be available under the given address.

    Control0..*
    TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
    Default Typehttp://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelUseable Period
    68. Act.text.reference.use
    Definition

    One or more codes advising a system or user which telecommunication address in a set of like addresses to select for a given telecommunication need.

    Control0..*
    BindingThe codes SHALL be taken from TelecommunicationAddressUse (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-TelecommunicationAddressUse|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelUse Code
    70. Act.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.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelThumbnail
    72. Act.statusCode
    ShortIndicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

    Control1..1
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    74. Act.effectiveTime
    ShortThe effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
    Comments

    SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
    Invariantsshould-value-att: SHOULD contain @value (value.exists())
    76. Act.effectiveTime.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    78. Act.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.

    Comments

    This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

    Control0..1
    TypedateTime(ts: Point in Time)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    XML FormatIn the XML format, this property is represented as an attribute.
    80. Act.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.

    Control0..1
    BindingThe codes SHALL be taken from CDASetOperator
    (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Default ValueI
    82. Act.effectiveTime.low
    Definition

    This is the low limit of the interval.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
    LabelLow Boundary
    84. Act.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.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
    LabelCentral Value
    86. Act.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.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
    LabelWidth
    88. Act.effectiveTime.high
    Definition

    This is the high limit of the interval.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
    LabelHigh Boundary
    90. Act.priorityCode
    Control0..1
    BindingFor example codes, see ActPriority
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    92. Act.languageCode
    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    94. Act.subject
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
    96. Act.specimen
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
    98. Act.performer
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
    100. Act.author
    ShortRepresents the person(s) who wrote the note.
    Comments

    SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

    Control1..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
    102. Act.informant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
    104. Act.participant
    Comments

    MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
    SlicingThis element introduces a set of slices on Act.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ typeCode
    • 106. Act.participant:legalAuthenticator
      Slice NamelegalAuthenticator
      ShortRepresents the person(s) legally responsible for the contents of the note.
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
      108. Act.participant:legalAuthenticator.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      110. Act.participant:legalAuthenticator.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      112. Act.participant:legalAuthenticator.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.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      114. Act.participant:legalAuthenticator.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      116. Act.participant:legalAuthenticator.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.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      118. Act.participant:legalAuthenticator.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).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      120. Act.participant:legalAuthenticator.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      122. Act.participant:legalAuthenticator.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      124. Act.participant:legalAuthenticator.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      126. Act.participant:legalAuthenticator.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

      Control1..1
      BindingThe codes SHALL be taken from CDAParticipationType
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueLA
      128. Act.participant:legalAuthenticator.contextControlCode
      Control0..1
      BindingThe codes SHALL be taken from CDAContextControl
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAContextControl)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueOP
      130. Act.participant:legalAuthenticator.sdtcFunctionCode
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namefunctionCode.
      132. Act.participant:legalAuthenticator.time
      ShortIndicates the time of signing the note.
      Comments

      SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
      134. Act.participant:legalAuthenticator.awarenessCode
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      136. Act.participant:legalAuthenticator.participantRole
      Comments

      SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
      Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
      138. Act.participant:legalAuthenticator.participantRole.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      140. Act.participant:legalAuthenticator.participantRole.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      142. Act.participant:legalAuthenticator.participantRole.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.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      144. Act.participant:legalAuthenticator.participantRole.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      146. Act.participant:legalAuthenticator.participantRole.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.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      148. Act.participant:legalAuthenticator.participantRole.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).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      150. Act.participant:legalAuthenticator.participantRole.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      152. Act.participant:legalAuthenticator.participantRole.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      154. Act.participant:legalAuthenticator.participantRole.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      156. Act.participant:legalAuthenticator.participantRole.classCode
      Control0..1
      BindingThe codes SHALL be taken from CDARoleClassRoot
      (required to http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default ValueROL
      158. Act.participant:legalAuthenticator.participantRole.id
      ShortThis may be the ID of the note author. If so, no additional information in this participant is required.
      Comments

      This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

      Control1..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      160. Act.participant:legalAuthenticator.participantRole.sdtcIdentifiedBy
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameidentifiedBy.
      162. Act.participant:legalAuthenticator.participantRole.code
      Control0..1
      BindingFor example codes, see CDARoleCode
      (example to http://hl7.org/cda/stds/core/ValueSet/CDARoleCode)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      164. Act.participant:legalAuthenticator.participantRole.addr
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD
      166. Act.participant:legalAuthenticator.participantRole.telecom
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
      168. Act.participant:legalAuthenticator.participantRole.playingDevice
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Device
      170. Act.participant:legalAuthenticator.participantRole.playingEntity
      Comments

      This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
      172. Act.participant:legalAuthenticator.participantRole.playingEntity.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      174. Act.participant:legalAuthenticator.participantRole.playingEntity.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      176. Act.participant:legalAuthenticator.participantRole.playingEntity.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.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      178. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      180. Act.participant:legalAuthenticator.participantRole.playingEntity.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.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      182. Act.participant:legalAuthenticator.participantRole.playingEntity.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).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      184. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      186. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      188. Act.participant:legalAuthenticator.participantRole.playingEntity.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

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      190. Act.participant:legalAuthenticator.participantRole.playingEntity.classCode
      Control0..1
      BindingThe codes SHALL be taken from EntityClassRoot
      (required to http://terminology.hl7.org/ValueSet/v3-EntityClassRoot)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default ValueENT
      192. Act.participant:legalAuthenticator.participantRole.playingEntity.determinerCode
      Control0..1
      BindingThe codes SHALL be taken from EntityDeterminer
      (required to http://terminology.hl7.org/ValueSet/v3-EntityDeterminer)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueINSTANCE
      194. Act.participant:legalAuthenticator.participantRole.playingEntity.code
      Control0..1
      BindingFor example codes, see CDAEntityCode
      (example to http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      196. Act.participant:legalAuthenticator.participantRole.playingEntity.quantity
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
      198. Act.participant:legalAuthenticator.participantRole.playingEntity.name
      Comments

      The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

      Control1..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
      200. Act.participant:legalAuthenticator.participantRole.playingEntity.sdtcBirthTime
      Definition

      The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namebirthTime.
      202. Act.participant:legalAuthenticator.participantRole.playingEntity.desc
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
      204. Act.participant:legalAuthenticator.participantRole.scopingEntity
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Entity
      206. Act.entryRelationship
      Comments

      SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • exists @ encounter
      • 208. Act.entryRelationship:encounter
        Slice Nameencounter
        ShortLinks the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
        210. Act.entryRelationship:encounter.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        212. Act.entryRelationship:encounter.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

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        214. Act.entryRelationship:encounter.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.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
        216. Act.entryRelationship:encounter.typeId.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        218. Act.entryRelationship:encounter.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.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        220. Act.entryRelationship:encounter.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).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        222. Act.entryRelationship:encounter.typeId.root
        Definition

        Identifies the type as an HL7 Registered model

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Fixed Value2.16.840.1.113883.1.3
        224. Act.entryRelationship:encounter.typeId.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        226. Act.entryRelationship:encounter.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

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        228. Act.entryRelationship:encounter.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

        Control1..1
        BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
        (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueCOMP
        230. Act.entryRelationship:encounter.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.

        Comments

        SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

        Control1..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed Valuetrue
        232. Act.entryRelationship:encounter.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.

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Default Valuetrue
        234. Act.entryRelationship:encounter.negationInd
        ShortTo communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
        Comments

        MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        236. Act.entryRelationship:encounter.sequenceNumber
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
        238. Act.entryRelationship:encounter.seperatableInd
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
        240. Act.entryRelationship:encounter.act
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
        242. Act.entryRelationship:encounter.encounter
        Comments

        SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
        244. Act.entryRelationship:encounter.encounter.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        246. Act.entryRelationship:encounter.encounter.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

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        248. Act.entryRelationship:encounter.encounter.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.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
        250. Act.entryRelationship:encounter.encounter.typeId.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        252. Act.entryRelationship:encounter.encounter.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.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        254. Act.entryRelationship:encounter.encounter.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).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        256. Act.entryRelationship:encounter.encounter.typeId.root
        Definition

        Identifies the type as an HL7 Registered model

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Fixed Value2.16.840.1.113883.1.3
        258. Act.entryRelationship:encounter.encounter.typeId.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        260. Act.entryRelationship:encounter.encounter.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

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        262. Act.entryRelationship:encounter.encounter.classCode
        Control1..1
        BindingThe codes SHALL be taken from CDAActClass
        (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClass)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueENC
        264. Act.entryRelationship:encounter.encounter.moodCode
        Control1..1
        BindingThe codes SHALL be taken from XDocumentEncounterMood (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        266. Act.entryRelationship:encounter.encounter.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).


        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.

        Control10..*1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
        Is Modifierfalse
        Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
        268. Act.entryRelationship:encounter.encounter.code
        Control0..1
        BindingFor example codes, see ActEncounterCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        270. Act.entryRelationship:encounter.encounter.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.

        ShortText 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.

        Control0..1
        This element is affected by the following invariants: dom-6
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
        Is Modifierfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        272. Act.entryRelationship:encounter.encounter.statusCode
        Control0..1
        BindingThe codes SHALL be taken from ActStatus
        (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        274. Act.entryRelationship:encounter.encounter.effectiveTime
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
        276. Act.entryRelationship:encounter.encounter.sdtcDischargeDispositionCode
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namedischargeDispositionCode.
        278. Act.entryRelationship:encounter.encounter.priorityCode
        Control0..1
        BindingFor example codes, see ActPriority
        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        280. Act.entryRelationship:encounter.encounter.subject
        Definition

        The patient or group related to this encounter. In some use-cases the patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam.

        ShortThe patient or group related to this encounter
        Comments

        While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group)
        Is Modifierfalse
        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        282. Act.entryRelationship:encounter.encounter.specimen
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
        284. Act.entryRelationship:encounter.encounter.performer
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
        286. Act.entryRelationship:encounter.encounter.author
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
        288. Act.entryRelationship:encounter.encounter.informant
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
        290. Act.entryRelationship:encounter.encounter.participant
        Definition

        The list of people responsible for providing the service.

        ShortList of participants involved in the encounter
        Comments

        Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2BackboneElement
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
        enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
        292. Act.entryRelationship:encounter.encounter.entryRelationship
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
        294. Act.entryRelationship:encounter.encounter.reference
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
        296. Act.entryRelationship:encounter.encounter.precondition
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
        298. Act.entryRelationship:encounter.encounter.sdtcPrecondition2
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
        300. Act.entryRelationship:encounter.encounter.sdtcInFulfillmentOf1
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.
        302. Act.entryRelationship:encounter.observation
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
        304. Act.entryRelationship:encounter.observationMedia
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
        306. Act.entryRelationship:encounter.organizer
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
        308. Act.entryRelationship:encounter.procedure
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
        310. Act.entryRelationship:encounter.regionOfInterest
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
        312. Act.entryRelationship:encounter.substanceAdministration
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
        314. Act.entryRelationship:encounter.supply
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
        316. Act.reference
        Comments

        MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
        SlicingThis element introduces a set of slices on Act.reference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • exists @ externalDocument
        • 318. Act.reference:externalDocument
          Slice NameexternalDocument
          ShortRepresents an unstructured C-CDA document containing the original contents of the note in the original format.
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
          320. Act.reference:externalDocument.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          322. Act.reference:externalDocument.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

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          324. Act.reference:externalDocument.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.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
          326. Act.reference:externalDocument.typeId.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          328. Act.reference:externalDocument.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.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          330. Act.reference:externalDocument.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).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          332. Act.reference:externalDocument.typeId.root
          Definition

          Identifies the type as an HL7 Registered model

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Fixed Value2.16.840.1.113883.1.3
          334. Act.reference:externalDocument.typeId.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          336. Act.reference:externalDocument.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

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          338. Act.reference:externalDocument.typeCode
          Control1..1
          BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
          (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          340. Act.reference:externalDocument.seperatableInd
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
          342. Act.reference:externalDocument.externalAct
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
          344. Act.reference:externalDocument.externalObservation
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
          346. Act.reference:externalDocument.externalProcedure
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
          348. Act.reference:externalDocument.externalDocument
          Comments

          SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
          Invariantsshould-code: SHOULD contain code (code.exists())
          350. Act.reference:externalDocument.externalDocument.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          352. Act.reference:externalDocument.externalDocument.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

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          354. Act.reference:externalDocument.externalDocument.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.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
          356. Act.reference:externalDocument.externalDocument.typeId.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          358. Act.reference:externalDocument.externalDocument.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.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          360. Act.reference:externalDocument.externalDocument.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).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          362. Act.reference:externalDocument.externalDocument.typeId.root
          Definition

          Identifies the type as an HL7 Registered model

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Fixed Value2.16.840.1.113883.1.3
          364. Act.reference:externalDocument.externalDocument.typeId.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          366. Act.reference:externalDocument.externalDocument.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

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          368. Act.reference:externalDocument.externalDocument.classCode
          Control0..1
          BindingThe codes SHALL be taken from ActClassDocument
          (required to http://terminology.hl7.org/ValueSet/v3-ActClassDocument)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Default ValueDOC
          370. Act.reference:externalDocument.externalDocument.moodCode
          Control0..1
          BindingThe codes SHALL be taken from CDAActMood
          (required to http://hl7.org/cda/stds/core/ValueSet/CDAActMood)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValueEVN
          372. Act.reference:externalDocument.externalDocument.id
          Comments

          This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          374. Act.reference:externalDocument.externalDocument.code
          Comments

          This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

          Control0..1
          BindingFor example codes, see FHIRDocumentTypeCodes
          (example to http://hl7.org/fhir/ValueSet/doc-typecodes)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          376. Act.reference:externalDocument.externalDocument.text
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
          378. Act.reference:externalDocument.externalDocument.setId
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          380. Act.reference:externalDocument.externalDocument.versionNumber
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
          382. Act.reference:externalDocument.externalDocument.sdtcAuthor
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameauthor.
          384. Act.precondition
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
          386. Act.sdtcPrecondition2
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
          388. Act.sdtcInFulfillmentOf1
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

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

          0. Act
          Logical ContainerClinicalDocument (CDA Class)
          ValidationInstance of this type are validated by templateId
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
          Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
          2. Act.templateId
          Control1..?
          SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ root
          • value @ extension
          • 4. Act.templateId:note-activity
            Slice Namenote-activity
            Control1..1
            6. Act.templateId:note-activity.root
            Control1..?
            Pattern Value2.16.840.1.113883.10.20.22.4.202
            8. Act.templateId:note-activity.extension
            Control1..?
            Pattern Value2026-05-01
            10. Act.classCode
            Comments

            SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

            Fixed ValueACT
            12. Act.moodCode
            Comments

            SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

            Fixed ValueEVN
            14. Act.code
            BindingThe codes SHALL be taken from US Core DocumentReference Type
            (required to http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type)
            16. Act.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Comments

            SHALL contain exactly one [1..1] text (CONF:3250-16896).

            Control1..?
            This element is affected by the following invariants: should-text-ref-value
            Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (mediaType.exists() implies (representation = 'B64' and xmlText.exists()))
            18. Act.text.mediaType
            ShortIf the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
            Comments

            This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

            BindingThe codes SHOULD be taken from SupportedFileFormats .
            (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1)
            20. Act.text.reference
            Comments

            This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

            Control1..?
            Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
            22. Act.text.reference.nullFlavor
            ShortThe note activity must reference human-readable content in the narrative, so this reference must not be null.
            Comments

            This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

            Control0..0
            24. Act.text.reference.value
            Comments

            This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

            Control1..?
            26. Act.statusCode
            ShortIndicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
            Comments

            SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

            Control1..?
            28. Act.effectiveTime
            ShortThe effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
            Comments

            SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

            Control1..?
            Invariantsshould-value-att: SHOULD contain @value (value.exists())
            30. Act.effectiveTime.value
            Comments

            This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

            32. Act.author
            ShortRepresents the person(s) who wrote the note.
            Comments

            SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

            Control1..?
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
            34. Act.participant
            Comments

            MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

            SlicingThis element introduces a set of slices on Act.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ typeCode
            • 36. Act.participant:legalAuthenticator
              Slice NamelegalAuthenticator
              ShortRepresents the person(s) legally responsible for the contents of the note.
              Control0..*
              38. Act.participant:legalAuthenticator.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

              Fixed ValueLA
              40. Act.participant:legalAuthenticator.time
              ShortIndicates the time of signing the note.
              Comments

              SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

              Control1..?
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
              42. Act.participant:legalAuthenticator.participantRole
              Comments

              SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

              Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
              44. Act.participant:legalAuthenticator.participantRole.id
              ShortThis may be the ID of the note author. If so, no additional information in this participant is required.
              Comments

              This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

              Control1..?
              46. Act.participant:legalAuthenticator.participantRole.playingEntity
              Comments

              This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

              48. Act.participant:legalAuthenticator.participantRole.playingEntity.name
              Comments

              The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

              Control1..?
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
              50. Act.entryRelationship
              Comments

              SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

              SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • exists @ encounter
              • 52. Act.entryRelationship:encounter
                Slice Nameencounter
                ShortLinks the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
                Control0..*
                54. Act.entryRelationship:encounter.typeCode
                Comments

                SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

                Fixed ValueCOMP
                56. Act.entryRelationship:encounter.inversionInd
                Comments

                SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

                Control1..?
                Fixed Valuetrue
                58. Act.entryRelationship:encounter.negationInd
                ShortTo communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
                Comments

                MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

                60. Act.entryRelationship:encounter.encounter
                Comments

                SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

                Control1..?
                62. Act.entryRelationship:encounter.encounter.id
                Comments

                This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).

                Control1..?
                Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
                64. Act.reference
                Comments

                MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

                SlicingThis element introduces a set of slices on Act.reference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • exists @ externalDocument
                • 66. Act.reference:externalDocument
                  Slice NameexternalDocument
                  ShortRepresents an unstructured C-CDA document containing the original contents of the note in the original format.
                  Control0..*
                  68. Act.reference:externalDocument.externalDocument
                  Comments

                  SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

                  Control1..?
                  Invariantsshould-code: SHOULD contain code (code.exists())
                  70. Act.reference:externalDocument.externalDocument.id
                  Comments

                  This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

                  Control1..1
                  72. Act.reference:externalDocument.externalDocument.code
                  Comments

                  This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

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

                  0. 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.

                  ShortBase for all types and resources
                  Control1..1
                  Is Modifierfalse
                  Logical ContainerClinicalDocument (CDA Class)
                  ValidationInstance of this type are validated by templateId
                  XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
                  Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
                  2. Act.nullFlavor
                  Definition

                  If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                  Control0..1
                  BindingThe codes SHALL be taken from CDANullFlavor
                  (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                  Typecode(cs: Coded Simple Value)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelExceptional Value Detail
                  4. Act.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

                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                  6. Act.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.

                  Control0..1
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                  InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                  8. Act.typeId.nullFlavor
                  Definition

                  If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                  Control0..1
                  BindingThe codes SHALL be taken from CDANullFlavor
                  (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                  Typecode(cs: Coded Simple Value)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelExceptional Value Detail
                  10. Act.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.

                  Control0..1
                  Typestring(st: Character String)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelAssigning Authority Name
                  12. Act.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).

                  Control0..1
                  Typeboolean(bl: Boolean)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelDisplayable
                  14. Act.typeId.root
                  Definition

                  Identifies the type as an HL7 Registered model

                  Control1..1
                  Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelRoot
                  Fixed Value2.16.840.1.113883.1.3
                  16. Act.typeId.extension
                  Definition

                  A character string as a unique identifier within the scope of the identifier root.

                  Control1..1
                  Typestring(st: Character String)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelExtension
                  18. Act.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

                  Control1..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                  SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ root
                  • value @ extension
                  • 20. Act.templateId:note-activity
                    Slice Namenote-activity
                    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

                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    22. Act.templateId:note-activity.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    24. Act.templateId:note-activity.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.

                    Control0..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelAssigning Authority Name
                    26. Act.templateId:note-activity.displayable
                    Definition

                    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelDisplayable
                    28. Act.templateId:note-activity.root
                    Definition

                    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

                    Control1..1
                    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelRoot
                    Pattern Value2.16.840.1.113883.10.20.22.4.202
                    30. Act.templateId:note-activity.extension
                    Definition

                    A character string as a unique identifier within the scope of the identifier root.

                    Control1..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExtension
                    Pattern Value2026-05-01
                    32. Act.classCode
                    Comments

                    SHALL contain exactly one [1..1] @classCode="ACT" Act (CONF:3250-16899).

                    Control1..1
                    BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
                    (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValueACT
                    34. Act.moodCode
                    Comments

                    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:3250-16900).

                    Control1..1
                    BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
                    (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValueEVN
                    36. Act.negationInd
                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    38. Act.id
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    40. Act.code
                    Control1..1
                    BindingThe codes SHALL be taken from US Core DocumentReference Type
                    (required to http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type)
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                    42. Act.text
                    ShortSHOULD reference the portion of section narrative text corresponding to this entry
                    Comments

                    SHALL contain exactly one [1..1] text (CONF:3250-16896).

                    Control1..1
                    This element is affected by the following invariants: should-text-ref-value
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                    Invariants3250-16912: If @mediaType is present, the text SHALL contain exactly one [1..1] @representation="B64" and mixed content corresponding to the contents of the note (CONF:3250-16912). (mediaType.exists() implies (representation = 'B64' and xmlText.exists()))
                    44. Act.text.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    46. Act.text.compression
                    Definition

                    Indicates whether the raw byte data is compressed, and what compression algorithm was used.

                    Control0..1
                    BindingThe codes SHALL be taken from CDACompressionAlgorithm
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelCompression
                    48. Act.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.

                    Control0..1
                    Typebase64Binary(bin: Binary Data)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelIntegrity Check
                    50. Act.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.

                    Control0..1
                    BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
                    (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelIntegrity Check Algorithm
                    52. Act.text.language
                    Definition

                    For character based information the language property specifies the human language of the text.

                    Control0..1
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelLanguage
                    54. Act.text.mediaType
                    Definition

                    Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

                    ShortIf the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative.
                    Comments

                    This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).

                    Control0..1
                    BindingThe codes SHOULD be taken from SupportedFileFormats .
                    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.7.1)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelMedia Type
                    56. Act.text.representation
                    Control0..1
                    BindingThe codes SHALL be taken from CDABinaryDataEncoding
                    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    58. Act.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.)

                    ShortAllows 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.

                    Control0..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as unadorned text.
                    60. Act.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.

                    Comments

                    This text SHALL contain exactly one [1..1] reference (CONF:3250-16897).

                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
                    LabelReference
                    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
                    62. Act.text.reference.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    ShortThe note activity must reference human-readable content in the narrative, so this reference must not be null.
                    Comments

                    This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).

                    Control0..0
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    64. Act.text.reference.value
                    Comments

                    This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898).

                    Control1..1
                    Typeurl(url: Universal Resource Locator)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    66. Act.text.reference.useablePeriod
                    Definition

                    Specifies the periods of time during which the telecommunication address can be used. For a telephone number, this can indicate the time of day in which the party can be reached on that telephone. For a web address, it may specify a time range in which the web content is promised to be available under the given address.

                    Control0..*
                    TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
                    Default Typehttp://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS
                    XML FormatThe type of this property is determined using the xsi:typeattribute.
                    LabelUseable Period
                    68. Act.text.reference.use
                    Definition

                    One or more codes advising a system or user which telecommunication address in a set of like addresses to select for a given telecommunication need.

                    Control0..*
                    BindingThe codes SHALL be taken from TelecommunicationAddressUse (2.0.0)
                    (required to http://terminology.hl7.org/ValueSet/v3-TelecommunicationAddressUse|2.0.0)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelUse Code
                    70. Act.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.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                    LabelThumbnail
                    72. Act.statusCode
                    ShortIndicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized.
                    Comments

                    SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).

                    Control1..1
                    BindingThe codes SHALL be taken from ActStatus
                    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                    74. Act.effectiveTime
                    ShortThe effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time.
                    Comments

                    SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).

                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
                    Invariantsshould-value-att: SHOULD contain @value (value.exists())
                    76. Act.effectiveTime.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    78. Act.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.

                    Comments

                    This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917).

                    Control0..1
                    TypedateTime(ts: Point in Time)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
                    XML FormatIn the XML format, this property is represented as an attribute.
                    80. Act.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.

                    Control0..1
                    BindingThe codes SHALL be taken from CDASetOperator
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Default ValueI
                    82. Act.effectiveTime.low
                    Definition

                    This is the low limit of the interval.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
                    LabelLow Boundary
                    84. Act.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.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
                    LabelCentral Value
                    86. Act.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.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
                    LabelWidth
                    88. Act.effectiveTime.high
                    Definition

                    This is the high limit of the interval.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
                    LabelHigh Boundary
                    90. Act.priorityCode
                    Control0..1
                    BindingFor example codes, see ActPriority
                    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                    92. Act.languageCode
                    Control0..1
                    BindingThe codes SHALL be taken from AllLanguages
                    (required to http://hl7.org/fhir/ValueSet/all-languages)
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                    94. Act.subject
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
                    96. Act.specimen
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
                    98. Act.performer
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
                    100. Act.author
                    ShortRepresents the person(s) who wrote the note.
                    Comments

                    SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).

                    Control1..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
                    102. Act.informant
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
                    104. Act.participant
                    Comments

                    MAY contain zero or more [0..*] participant (CONF:3250-16923) such that it

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
                    SlicingThis element introduces a set of slices on Act.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ typeCode
                    • 106. Act.participant:legalAuthenticator
                      Slice NamelegalAuthenticator
                      ShortRepresents the person(s) legally responsible for the contents of the note.
                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
                      108. Act.participant:legalAuthenticator.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      110. Act.participant:legalAuthenticator.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                      112. Act.participant:legalAuthenticator.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.

                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                      114. Act.participant:legalAuthenticator.typeId.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      116. Act.participant:legalAuthenticator.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.

                      Control0..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelAssigning Authority Name
                      118. Act.participant:legalAuthenticator.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).

                      Control0..1
                      Typeboolean(bl: Boolean)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelDisplayable
                      120. Act.participant:legalAuthenticator.typeId.root
                      Definition

                      Identifies the type as an HL7 Registered model

                      Control1..1
                      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelRoot
                      Fixed Value2.16.840.1.113883.1.3
                      122. Act.participant:legalAuthenticator.typeId.extension
                      Definition

                      A character string as a unique identifier within the scope of the identifier root.

                      Control1..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExtension
                      124. Act.participant:legalAuthenticator.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      126. Act.participant:legalAuthenticator.typeCode
                      Comments

                      SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925).

                      Control1..1
                      BindingThe codes SHALL be taken from CDAParticipationType
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed ValueLA
                      128. Act.participant:legalAuthenticator.contextControlCode
                      Control0..1
                      BindingThe codes SHALL be taken from CDAContextControl
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDAContextControl)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed ValueOP
                      130. Act.participant:legalAuthenticator.sdtcFunctionCode
                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namefunctionCode.
                      132. Act.participant:legalAuthenticator.time
                      ShortIndicates the time of signing the note.
                      Comments

                      SHALL contain exactly one [1..1] US Realm Date and Time (Interval) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).

                      Control1..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS(US Realm Date and Time - Interval)
                      134. Act.participant:legalAuthenticator.awarenessCode
                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                      136. Act.participant:legalAuthenticator.participantRole
                      Comments

                      SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).

                      Control1..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
                      Invariants3250-16930: If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present (CONF:3250-16930). ()
                      138. Act.participant:legalAuthenticator.participantRole.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      140. Act.participant:legalAuthenticator.participantRole.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                      142. Act.participant:legalAuthenticator.participantRole.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.

                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                      144. Act.participant:legalAuthenticator.participantRole.typeId.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      146. Act.participant:legalAuthenticator.participantRole.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.

                      Control0..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelAssigning Authority Name
                      148. Act.participant:legalAuthenticator.participantRole.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).

                      Control0..1
                      Typeboolean(bl: Boolean)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelDisplayable
                      150. Act.participant:legalAuthenticator.participantRole.typeId.root
                      Definition

                      Identifies the type as an HL7 Registered model

                      Control1..1
                      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelRoot
                      Fixed Value2.16.840.1.113883.1.3
                      152. Act.participant:legalAuthenticator.participantRole.typeId.extension
                      Definition

                      A character string as a unique identifier within the scope of the identifier root.

                      Control1..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExtension
                      154. Act.participant:legalAuthenticator.participantRole.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      156. Act.participant:legalAuthenticator.participantRole.classCode
                      Control0..1
                      BindingThe codes SHALL be taken from CDARoleClassRoot
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Default ValueROL
                      158. Act.participant:legalAuthenticator.participantRole.id
                      ShortThis may be the ID of the note author. If so, no additional information in this participant is required.
                      Comments

                      This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).

                      Control1..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      160. Act.participant:legalAuthenticator.participantRole.sdtcIdentifiedBy
                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
                      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameidentifiedBy.
                      162. Act.participant:legalAuthenticator.participantRole.code
                      Control0..1
                      BindingFor example codes, see CDARoleCode
                      (example to http://hl7.org/cda/stds/core/ValueSet/CDARoleCode)
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                      164. Act.participant:legalAuthenticator.participantRole.addr
                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD
                      166. Act.participant:legalAuthenticator.participantRole.telecom
                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
                      168. Act.participant:legalAuthenticator.participantRole.playingDevice
                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Device
                      170. Act.participant:legalAuthenticator.participantRole.playingEntity
                      Comments

                      This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928).

                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
                      172. Act.participant:legalAuthenticator.participantRole.playingEntity.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      174. Act.participant:legalAuthenticator.participantRole.playingEntity.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                      176. Act.participant:legalAuthenticator.participantRole.playingEntity.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.

                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                      178. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.nullFlavor
                      Definition

                      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                      Control0..1
                      BindingThe codes SHALL be taken from CDANullFlavor
                      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExceptional Value Detail
                      180. Act.participant:legalAuthenticator.participantRole.playingEntity.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.

                      Control0..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelAssigning Authority Name
                      182. Act.participant:legalAuthenticator.participantRole.playingEntity.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).

                      Control0..1
                      Typeboolean(bl: Boolean)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelDisplayable
                      184. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.root
                      Definition

                      Identifies the type as an HL7 Registered model

                      Control1..1
                      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelRoot
                      Fixed Value2.16.840.1.113883.1.3
                      186. Act.participant:legalAuthenticator.participantRole.playingEntity.typeId.extension
                      Definition

                      A character string as a unique identifier within the scope of the identifier root.

                      Control1..1
                      Typestring(st: Character String)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      LabelExtension
                      188. Act.participant:legalAuthenticator.participantRole.playingEntity.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

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                      190. Act.participant:legalAuthenticator.participantRole.playingEntity.classCode
                      Control0..1
                      BindingThe codes SHALL be taken from EntityClassRoot
                      (required to http://terminology.hl7.org/ValueSet/v3-EntityClassRoot)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Default ValueENT
                      192. Act.participant:legalAuthenticator.participantRole.playingEntity.determinerCode
                      Control0..1
                      BindingThe codes SHALL be taken from EntityDeterminer
                      (required to http://terminology.hl7.org/ValueSet/v3-EntityDeterminer)
                      Typecode(cs: Coded Simple Value)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed ValueINSTANCE
                      194. Act.participant:legalAuthenticator.participantRole.playingEntity.code
                      Control0..1
                      BindingFor example codes, see CDAEntityCode
                      (example to http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode)
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                      196. Act.participant:legalAuthenticator.participantRole.playingEntity.quantity
                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
                      198. Act.participant:legalAuthenticator.participantRole.playingEntity.name
                      Comments

                      The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929).

                      Control1..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
                      200. Act.participant:legalAuthenticator.participantRole.playingEntity.sdtcBirthTime
                      Definition

                      The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.

                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
                      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namebirthTime.
                      202. Act.participant:legalAuthenticator.participantRole.playingEntity.desc
                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                      204. Act.participant:legalAuthenticator.participantRole.scopingEntity
                      Control0..1
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Entity
                      206. Act.entryRelationship
                      Comments

                      SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it

                      Control0..*
                      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                      SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • exists @ encounter
                      • 208. Act.entryRelationship:encounter
                        Slice Nameencounter
                        ShortLinks the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter.
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                        210. Act.entryRelationship:encounter.nullFlavor
                        Definition

                        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                        Control0..1
                        BindingThe codes SHALL be taken from CDANullFlavor
                        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExceptional Value Detail
                        212. Act.entryRelationship:encounter.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

                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                        214. Act.entryRelationship:encounter.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.

                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                        216. Act.entryRelationship:encounter.typeId.nullFlavor
                        Definition

                        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                        Control0..1
                        BindingThe codes SHALL be taken from CDANullFlavor
                        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExceptional Value Detail
                        218. Act.entryRelationship:encounter.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.

                        Control0..1
                        Typestring(st: Character String)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelAssigning Authority Name
                        220. Act.entryRelationship:encounter.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).

                        Control0..1
                        Typeboolean(bl: Boolean)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelDisplayable
                        222. Act.entryRelationship:encounter.typeId.root
                        Definition

                        Identifies the type as an HL7 Registered model

                        Control1..1
                        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelRoot
                        Fixed Value2.16.840.1.113883.1.3
                        224. Act.entryRelationship:encounter.typeId.extension
                        Definition

                        A character string as a unique identifier within the scope of the identifier root.

                        Control1..1
                        Typestring(st: Character String)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExtension
                        226. Act.entryRelationship:encounter.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

                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                        228. Act.entryRelationship:encounter.typeCode
                        Comments

                        SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921).

                        Control1..1
                        BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
                        (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed ValueCOMP
                        230. Act.entryRelationship:encounter.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.

                        Comments

                        SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922).

                        Control1..1
                        Typeboolean(bl: Boolean)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuetrue
                        232. Act.entryRelationship:encounter.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.

                        Control0..1
                        Typeboolean(bl: Boolean)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Default Valuetrue
                        234. Act.entryRelationship:encounter.negationInd
                        ShortTo communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd="true" and encounter/id/@nullFlavor="NA". The negationInd + encounter indicate this note is not associated with any encounter.
                        Comments

                        MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).

                        Control0..1
                        Typeboolean(bl: Boolean)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        236. Act.entryRelationship:encounter.sequenceNumber
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
                        238. Act.entryRelationship:encounter.seperatableInd
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
                        240. Act.entryRelationship:encounter.act
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
                        242. Act.entryRelationship:encounter.encounter
                        Comments

                        SHALL contain exactly one [1..1] encounter (CONF:3250-16908).

                        Control1..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
                        244. Act.entryRelationship:encounter.encounter.nullFlavor
                        Definition

                        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                        Control0..1
                        BindingThe codes SHALL be taken from CDANullFlavor
                        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExceptional Value Detail
                        246. Act.entryRelationship:encounter.encounter.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

                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                        248. Act.entryRelationship:encounter.encounter.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.

                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                        250. Act.entryRelationship:encounter.encounter.typeId.nullFlavor
                        Definition

                        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                        Control0..1
                        BindingThe codes SHALL be taken from CDANullFlavor
                        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExceptional Value Detail
                        252. Act.entryRelationship:encounter.encounter.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.

                        Control0..1
                        Typestring(st: Character String)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelAssigning Authority Name
                        254. Act.entryRelationship:encounter.encounter.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).

                        Control0..1
                        Typeboolean(bl: Boolean)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelDisplayable
                        256. Act.entryRelationship:encounter.encounter.typeId.root
                        Definition

                        Identifies the type as an HL7 Registered model

                        Control1..1
                        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelRoot
                        Fixed Value2.16.840.1.113883.1.3
                        258. Act.entryRelationship:encounter.encounter.typeId.extension
                        Definition

                        A character string as a unique identifier within the scope of the identifier root.

                        Control1..1
                        Typestring(st: Character String)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        LabelExtension
                        260. Act.entryRelationship:encounter.encounter.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

                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                        262. Act.entryRelationship:encounter.encounter.classCode
                        Control1..1
                        BindingThe codes SHALL be taken from CDAActClass
                        (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClass)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed ValueENC
                        264. Act.entryRelationship:encounter.encounter.moodCode
                        Control1..1
                        BindingThe codes SHALL be taken from XDocumentEncounterMood (2.0.0)
                        (required to http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood|2.0.0)
                        Typecode(cs: Coded Simple Value)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        266. Act.entryRelationship:encounter.encounter.id
                        Comments

                        This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).

                        Control1..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                        Invariants3250-16914: If the id does not match an encounter/id from the Encounters Section or encompassingEncounter within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:3250-16914). ()
                        268. Act.entryRelationship:encounter.encounter.code
                        Control0..1
                        BindingFor example codes, see ActEncounterCode
                        (example to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                        270. Act.entryRelationship:encounter.encounter.text
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                        272. Act.entryRelationship:encounter.encounter.statusCode
                        Control0..1
                        BindingThe codes SHALL be taken from ActStatus
                        (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                        274. Act.entryRelationship:encounter.encounter.effectiveTime
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
                        276. Act.entryRelationship:encounter.encounter.sdtcDischargeDispositionCode
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namedischargeDispositionCode.
                        278. Act.entryRelationship:encounter.encounter.priorityCode
                        Control0..1
                        BindingFor example codes, see ActPriority
                        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                        280. Act.entryRelationship:encounter.encounter.subject
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
                        282. Act.entryRelationship:encounter.encounter.specimen
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
                        284. Act.entryRelationship:encounter.encounter.performer
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
                        286. Act.entryRelationship:encounter.encounter.author
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
                        288. Act.entryRelationship:encounter.encounter.informant
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
                        290. Act.entryRelationship:encounter.encounter.participant
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
                        292. Act.entryRelationship:encounter.encounter.entryRelationship
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                        294. Act.entryRelationship:encounter.encounter.reference
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
                        296. Act.entryRelationship:encounter.encounter.precondition
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
                        298. Act.entryRelationship:encounter.encounter.sdtcPrecondition2
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
                        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
                        300. Act.entryRelationship:encounter.encounter.sdtcInFulfillmentOf1
                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
                        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.
                        302. Act.entryRelationship:encounter.observation
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
                        304. Act.entryRelationship:encounter.observationMedia
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
                        306. Act.entryRelationship:encounter.organizer
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
                        308. Act.entryRelationship:encounter.procedure
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
                        310. Act.entryRelationship:encounter.regionOfInterest
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
                        312. Act.entryRelationship:encounter.substanceAdministration
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
                        314. Act.entryRelationship:encounter.supply
                        Control0..1
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
                        316. Act.reference
                        Comments

                        MAY contain zero or more [0..*] reference (CONF:3250-16910) such that it

                        Control0..*
                        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
                        SlicingThis element introduces a set of slices on Act.reference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • exists @ externalDocument
                        • 318. Act.reference:externalDocument
                          Slice NameexternalDocument
                          ShortRepresents an unstructured C-CDA document containing the original contents of the note in the original format.
                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
                          320. Act.reference:externalDocument.nullFlavor
                          Definition

                          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                          Control0..1
                          BindingThe codes SHALL be taken from CDANullFlavor
                          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExceptional Value Detail
                          322. Act.reference:externalDocument.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

                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                          324. Act.reference:externalDocument.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.

                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                          326. Act.reference:externalDocument.typeId.nullFlavor
                          Definition

                          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                          Control0..1
                          BindingThe codes SHALL be taken from CDANullFlavor
                          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExceptional Value Detail
                          328. Act.reference:externalDocument.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.

                          Control0..1
                          Typestring(st: Character String)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelAssigning Authority Name
                          330. Act.reference:externalDocument.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).

                          Control0..1
                          Typeboolean(bl: Boolean)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelDisplayable
                          332. Act.reference:externalDocument.typeId.root
                          Definition

                          Identifies the type as an HL7 Registered model

                          Control1..1
                          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelRoot
                          Fixed Value2.16.840.1.113883.1.3
                          334. Act.reference:externalDocument.typeId.extension
                          Definition

                          A character string as a unique identifier within the scope of the identifier root.

                          Control1..1
                          Typestring(st: Character String)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExtension
                          336. Act.reference:externalDocument.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

                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          338. Act.reference:externalDocument.typeCode
                          Control1..1
                          BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
                          (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          340. Act.reference:externalDocument.seperatableInd
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
                          342. Act.reference:externalDocument.externalAct
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
                          344. Act.reference:externalDocument.externalObservation
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
                          346. Act.reference:externalDocument.externalProcedure
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
                          348. Act.reference:externalDocument.externalDocument
                          Comments

                          SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911).

                          Control1..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
                          Invariantsshould-code: SHOULD contain code (code.exists())
                          350. Act.reference:externalDocument.externalDocument.nullFlavor
                          Definition

                          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                          Control0..1
                          BindingThe codes SHALL be taken from CDANullFlavor
                          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExceptional Value Detail
                          352. Act.reference:externalDocument.externalDocument.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

                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                          354. Act.reference:externalDocument.externalDocument.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.

                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                          356. Act.reference:externalDocument.externalDocument.typeId.nullFlavor
                          Definition

                          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                          Control0..1
                          BindingThe codes SHALL be taken from CDANullFlavor
                          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExceptional Value Detail
                          358. Act.reference:externalDocument.externalDocument.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.

                          Control0..1
                          Typestring(st: Character String)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelAssigning Authority Name
                          360. Act.reference:externalDocument.externalDocument.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).

                          Control0..1
                          Typeboolean(bl: Boolean)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelDisplayable
                          362. Act.reference:externalDocument.externalDocument.typeId.root
                          Definition

                          Identifies the type as an HL7 Registered model

                          Control1..1
                          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelRoot
                          Fixed Value2.16.840.1.113883.1.3
                          364. Act.reference:externalDocument.externalDocument.typeId.extension
                          Definition

                          A character string as a unique identifier within the scope of the identifier root.

                          Control1..1
                          Typestring(st: Character String)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          LabelExtension
                          366. Act.reference:externalDocument.externalDocument.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

                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          368. Act.reference:externalDocument.externalDocument.classCode
                          Control0..1
                          BindingThe codes SHALL be taken from ActClassDocument
                          (required to http://terminology.hl7.org/ValueSet/v3-ActClassDocument)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Default ValueDOC
                          370. Act.reference:externalDocument.externalDocument.moodCode
                          Control0..1
                          BindingThe codes SHALL be taken from CDAActMood
                          (required to http://hl7.org/cda/stds/core/ValueSet/CDAActMood)
                          Typecode(cs: Coded Simple Value)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed ValueEVN
                          372. Act.reference:externalDocument.externalDocument.id
                          Comments

                          This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915).

                          Control1..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          374. Act.reference:externalDocument.externalDocument.code
                          Comments

                          This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918).

                          Control0..1
                          BindingFor example codes, see FHIRDocumentTypeCodes
                          (example to http://hl7.org/fhir/ValueSet/doc-typecodes)
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                          376. Act.reference:externalDocument.externalDocument.text
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                          378. Act.reference:externalDocument.externalDocument.setId
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                          380. Act.reference:externalDocument.externalDocument.versionNumber
                          Control0..1
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
                          382. Act.reference:externalDocument.externalDocument.sdtcAuthor
                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
                          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameauthor.
                          384. Act.precondition
                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
                          386. Act.sdtcPrecondition2
                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
                          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
                          388. Act.sdtcInFulfillmentOf1
                          Control0..*
                          Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
                          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.