Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
• JSON

Logical Model: Notes Section

The Notes Section allow for inclusion of clinical documentation which does not fit precisely within any other C-CDA section. Multiple Notes sections may be included in a document provided they each include different types of note content as indicated by a different section.code. The Notes Section SHOULD NOT be used in place of a more specific C-CDA section. For example, notes about procedure should be placed within the Procedures Section, not a Notes Section. When a Notes Section is present, Note Activity entries contain structured information about the note information allowing it to be more machine processable.

Usage:

• Use this Logical Model: Progress Note

Formal Views of Template Content

Description of Template, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Section

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
code		1..1	CE	Binding: Note Types (preferred)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
act		1..1	NoteActivity	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
@ID		0..1	xs:ID
@classCode		0..1	cs	Binding: ActClassRecordOrganizer (required) Fixed Value: DOCSECT
@moodCode		0..1	cs	Binding: CDAActMood (required) Fixed Value: EVN
id		0..1	II
code		1..1	CE	Binding: Note Types (preferred)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
confidentialityCode		0..1	CE
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
author		0..*	Author
informant		0..*	Informant
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: x_ActRelationshipEntry (required)
@contextConductionInd		0..1	bl	Fixed Value: true
act	C	1..1	NoteActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
component		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Fixed Value: COMP
@contextConductionInd		0..1	bl	Fixed Value: true
section		1..1	Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode	required	Fixed Value: DOCSECT http://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode	required	Fixed Value: EVN http://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov
Section.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Section.entry:note.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeCode	required	XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor

Constraints

Id	Grade	Path(s)	Details	Requirements
II-1	error	Section.typeId, Section.entry:note.typeId, Section.component.typeId	An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists()
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()
should-text-ref-value	warning	Section.entry:note.act	SHOULD contain text/reference/@value : text.reference.value.exists()

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
@ID		0..1	xs:ID
@classCode		0..1	cs	Binding: ActClassRecordOrganizer (required) Fixed Value: DOCSECT
@moodCode		0..1	cs	Binding: CDAActMood (required) Fixed Value: EVN
id		0..1	II
code		1..1	CE	Binding: Note Types (preferred)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
confidentialityCode		0..1	CE
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
author		0..*	Author
informant		0..*	Informant
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: x_ActRelationshipEntry (required)
@contextConductionInd		0..1	bl	Fixed Value: true
act	C	1..1	NoteActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
component		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Fixed Value: COMP
@contextConductionInd		0..1	bl	Fixed Value: true
section		1..1	Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode	required	Fixed Value: DOCSECT http://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode	required	Fixed Value: EVN http://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov
Section.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Section.entry:note.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeCode	required	XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor

Constraints

Id	Grade	Path(s)	Details	Requirements
II-1	error	Section.typeId, Section.entry:note.typeId, Section.component.typeId	An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists()
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()
should-text-ref-value	warning	Section.entry:note.act	SHOULD contain text/reference/@value : text.reference.value.exists()

This structure is derived from Section

Summary

Mandatory: 9 elements(1 nested mandatory element)

Structures

This structure refers to these other structures:

• Note Activity (http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Section.templateId
• The element 1 is sliced based on the value of Section.entry

Differential View

This structure is derived from Section

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
code		1..1	CE	Binding: Note Types (preferred)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
act		1..1	NoteActivity	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
@ID		0..1	xs:ID
@classCode		0..1	cs	Binding: ActClassRecordOrganizer (required) Fixed Value: DOCSECT
@moodCode		0..1	cs	Binding: CDAActMood (required) Fixed Value: EVN
id		0..1	II
code		1..1	CE	Binding: Note Types (preferred)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
confidentialityCode		0..1	CE
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
author		0..*	Author
informant		0..*	Informant
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: x_ActRelationshipEntry (required)
@contextConductionInd		0..1	bl	Fixed Value: true
act	C	1..1	NoteActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
component		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Fixed Value: COMP
@contextConductionInd		0..1	bl	Fixed Value: true
section		1..1	Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode	required	Fixed Value: DOCSECT http://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode	required	Fixed Value: EVN http://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov
Section.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Section.entry:note.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeCode	required	XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor

Constraints

Id	Grade	Path(s)	Details	Requirements
II-1	error	Section.typeId, Section.entry:note.typeId, Section.component.typeId	An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists()
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()
should-text-ref-value	warning	Section.entry:note.act	SHOULD contain text/reference/@value : text.reference.value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Section	C	1..1	Section	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) shall-note-activity: If section/@nullFlavor is not present, SHALL contain at least one Note Activity
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:section		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.2.65
@extension		1..1	st	Required Pattern: 2016-11-01
@ID		0..1	xs:ID
@classCode		0..1	cs	Binding: ActClassRecordOrganizer (required) Fixed Value: DOCSECT
@moodCode		0..1	cs	Binding: CDAActMood (required) Fixed Value: EVN
id		0..1	II
code		1..1	CE	Binding: Note Types (preferred)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.1
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD
title		1..1	ST	This title should reflect the kind of notes included in this section, corresponding to the code.
text		1..1	xhtml	The narrative SHOULD contain human-readable representations using standard CDA narrative markup of each note to ensure widest compatibility with receivers. While allowed by CDA, the use of renderMultiMedia elements, which contain a referencedObject attribute pointing to an observationMedia or regionOfInterest element in the discrete entries, is discouraged in Note Sections because rendering support for these elements is not widespread.
confidentialityCode		0..1	CE
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
author		0..*	Author
informant		0..*	Informant
Slices for entry		0..*	Entry	Slice: Unordered, Open by profile:act
entry:note		0..*	Entry	If section/@nullFlavor is not present:
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: x_ActRelationshipEntry (required)
@contextConductionInd		0..1	bl	Fixed Value: true
act	C	1..1	NoteActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
component		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId	C	0..1	II	II-1: An II instance must have either a root or an nullFlavor.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Fixed Value: COMP
@contextConductionInd		0..1	bl	Fixed Value: true
section		1..1	Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode	required	Fixed Value: DOCSECT http://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode	required	Fixed Value: EVN http://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code	preferred	NoteTypes http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.68 from https://vsac.nlm.nih.gov
Section.code.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Section.entry:note.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:note.typeCode	required	XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor

Constraints

Id	Grade	Path(s)	Details	Requirements
II-1	error	Section.typeId, Section.entry:note.typeId, Section.component.typeId	An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists()
shall-note-activity	error	Section	If section/@nullFlavor is not present, SHALL contain at least one Note Activity : nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity')).exists()
should-text-ref-value	warning	Section.entry:note.act	SHOULD contain text/reference/@value : text.reference.value.exists()

This structure is derived from Section

Summary

Mandatory: 9 elements(1 nested mandatory element)

Structures

This structure refers to these other structures:

• Note Activity (http://hl7.org/cda/us/ccda/StructureDefinition/NoteActivity)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Section.templateId
• The element 1 is sliced based on the value of Section.entry

Other representations of profile: CSV, Excel