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

Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0 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: Policy Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PolicyActivity Version: 4.0.0
Draft as of 2025-10-02 Computable Name: PolicyActivity
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.61:2024-05-01

A policy activity represents the policy or program providing the coverage. The person for whom payment is being provided (i.e., the patient) is the covered party. The subscriber of the policy or program is represented as a participant that is the holder of the coverage. The payer is represented as the performer of the policy activity. Note that the absence of a Policy Activity Act is not confirmation the patient does not have coverage. A Patient's coverage may not have been documented yet or not known to the healthcare provider.

  • Absence of a Policy Activity Act may mean that the patient has no coverage or the healthcare provider may not know it.
  • A self pay payer type MAY be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs.

Templates Used

Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:

Optional EntryRelationships: AuthorizationActivity

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 3.0.0:

  • New Content

    • Formal Views of Template Content

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

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:policy-activity 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... code 0..1 CE
    ....... @nullFlavor 0..0
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... name 0..1 ON
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... time 0..1 IVL_TS
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... code 1..1 CE
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: COV
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... low 0..1 IVXB_TS
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Constraints: should-code-attr
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS sdtc:birthTime
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: HLD
    ..... time 0..1 IVL_TS
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... addr 0..1 USRealmAddress
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 AuthorizationActivity
    ...... @moodCode 1..1 cs EVN
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 Act
    ...... @classCode 1..1 cs Fixed Value: ACT
    ...... @moodCode 1..1 cs Fixed Value: DEF
    ...... id 1..* II Plan identifier
    ...... text 1..1 ED Name of the plan

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:policy-activity 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: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ....... templateId:authorization-activity 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: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ 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
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.templateId:policy-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.statusCode.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.performer:payer.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.performer:payer.​assignedEntity.representedOrganization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​classCode Base required EntityClassOrganization 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​standardIndustryClassCode Base example OrganizationIndustryClassNAICS 📦3.0.0 THO v6.5
    Act.performer:guarantor.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.operator Base required CDASetOperator 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23
    Act.participant:coverage-target.​participantRole.playingEntity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​classCode Base required EntityClassRoot 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​code Base example CDAEntityCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.templateId:authorization-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:authorization.​act.entryRelationship:target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951 error Act.entryRelationship:authorization.act.entryRelationship:target The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951). (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1 error Act.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    value-starts-octothorpe error Act.entryRelationship:authorization.act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:policy-activity 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: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ....... templateId:authorization-activity 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: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ 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
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.templateId:policy-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.statusCode.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.performer:payer.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.performer:payer.​assignedEntity.representedOrganization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​classCode Base required EntityClassOrganization 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​standardIndustryClassCode Base example OrganizationIndustryClassNAICS 📦3.0.0 THO v6.5
    Act.performer:guarantor.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.operator Base required CDASetOperator 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23
    Act.participant:coverage-target.​participantRole.playingEntity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​classCode Base required EntityClassRoot 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​code Base example CDAEntityCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.templateId:authorization-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:authorization.​act.entryRelationship:target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951 error Act.entryRelationship:authorization.act.entryRelationship:target The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951). (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1 error Act.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    value-starts-octothorpe error Act.entryRelationship:authorization.act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    This structure is derived from Act

    Summary

    Mandatory: 18 elements(16 nested mandatory elements)
    Fixed: 9 elements
    Prohibited: 5 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Act.templateId
    • The element 1 is sliced based on the value of Act.performer
    • The element 1 is sliced based on the value of Act.participant
    • The element 1 is sliced based on the value of Act.entryRelationship

    Differential View

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:policy-activity 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @code 1..1 cs Fixed Value: completed
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.87
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... code 0..1 CE
    ....... @nullFlavor 0..0
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... name 0..1 ON
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.88
    ...... @extension 0..0
    ..... @typeCode 1..1 cs
    ..... time 0..1 IVL_TS
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... code 1..1 CE
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.89
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: COV
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... low 0..1 IVXB_TS
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Constraints: should-code-attr
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ...... addr 0..1 USRealmAddress
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS sdtc:birthTime
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... templateId 1..1 II
    ...... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.90
    ...... @extension 0..0
    ..... @typeCode 1..1 cs Fixed Value: HLD
    ..... time 0..1 IVL_TS
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... addr 0..1 USRealmAddress
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 AuthorizationActivity
    ...... @moodCode 1..1 cs EVN
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 Act
    ...... @classCode 1..1 cs Fixed Value: ACT
    ...... @moodCode 1..1 cs Fixed Value: DEF
    ...... id 1..* II Plan identifier
    ...... text 1..1 ED Name of the plan

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:policy-activity 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: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ....... templateId:authorization-activity 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: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ 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
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.templateId:policy-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.statusCode.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.performer:payer.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.performer:payer.​assignedEntity.representedOrganization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​classCode Base required EntityClassOrganization 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​standardIndustryClassCode Base example OrganizationIndustryClassNAICS 📦3.0.0 THO v6.5
    Act.performer:guarantor.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.operator Base required CDASetOperator 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23
    Act.participant:coverage-target.​participantRole.playingEntity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​classCode Base required EntityClassRoot 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​code Base example CDAEntityCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.templateId:authorization-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:authorization.​act.entryRelationship:target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951 error Act.entryRelationship:authorization.act.entryRelationship:target The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951). (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1 error Act.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    value-starts-octothorpe error Act.entryRelationship:authorization.act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act XML Namespace: urn:hl7-org:v3
    Base for all types and resources
    Instance of this type are validated by templateId
    Logical Container: ClinicalDocument (CDA Class)
    Constraints: should-text-ref-value, 4537-17139
    ... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @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:policy-activity 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: 2.16.840.1.113883.10.20.22.4.61
    ..... @extension 1..1 st Required Pattern: 2024-05-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Group Identifier: This is the identifier (sent in the @extension attribute) used to uniquely refer to a specific health insurance plan.
    ... code 1..1 CD 𝗨𝗦𝗖𝗗𝗜: Coverage Type: Records the category of health care payers, insurance products, or benefits.
    Binding: Payer Type . (preferred)
    ... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail 0..1 ED
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Fixed Value: completed
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... Slices for performer 1..* Performer2 Slice: Unordered, Open by value:templateId.root
    .... performer:payer 1..1 Performer2 This performer represents the Payer.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.87
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: should-code, should-representedOrganization
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Payer Identifier: This is the Payer id. The root is a unique identifier to an openly available assigning authority, such as National Association of Insurance Commissioners (NAIC) (2.16.840.1.113883.6.300), and the extension identifiers the payer within that authority.
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ....... @code 1..1 cs Binding: Financially Responsible Party Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization C 0..1 Organization Constraints: should-name
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassOrganization (required)
    Fixed Value: ORG
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... id 0..* II
    ....... name 0..1 ON
    ....... telecom 0..* TEL
    ....... addr 0..* AD
    ....... standardIndustryClassCode 0..1 CE Binding: OrganizationIndustryClassNAICS (example)
    ....... asOrganizationPartOf 0..1 OrganizationPartOf
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    .... performer:guarantor C 0..* Performer2 This performer represents the Guarantor.
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.88
    ..... @typeCode 1..1 cs Binding: ParticipationPhysicalPerformer (required)
    Fixed Value: PRF
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... modeCode 0..1 CE
    ..... assignedEntity C 1..1 AssignedEntity Constraints: 4537-8967, should-addr, should-telecom
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: RoleClassAssignedEntity (required)
    Fixed Value: ASSIGNED
    ...... id 1..* II
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 1..1 CE Binding: CDARoleCode (example)
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 1..1 cs Required Pattern: GUAR
    ....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.110
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... assignedPerson 0..1 Person
    ...... representedOrganization 0..1 Organization
    ...... sdtcPatient 0..1 Base XML Namespace: urn:hl7-org:sdtc
    XML: patient (urn:hl7-org:sdtc)
    ....... id 1..1 II XML Namespace: urn:hl7-org:sdtc
    XML Namespace: urn:hl7-org:sdtc
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for participant 1..* Participant2 Slice: Unordered, Open by value:typeCode
    .... participant:coverage-target C 1..1 Participant2 participant
    Constraints: should-time
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.89
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: COV
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time C 0..1 IVL_TS This records the policy coverage period or self-pay period.
    Constraints: should-low, should-high
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @value 0..1 ts Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    ...... @operator 0..1 cs Binding: CDASetOperator (required)
    ...... low 0..1 IVXB_TS
    ...... center 0..1 TS
    ...... width 0..1 PQ
    ...... high 0..1 IVXB_TS SHOULD contain high
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr, should-playingEntity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Member Identifier: This id is a unique identifier for the covered party member. Implementers **SHOULD** use the same GUID for each instance of a member identifier from the same health plan (CONF:4537-8984).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code C 1..1 CE 𝗨𝗦𝗖𝗗𝗜: Relationship to Subscriber: Records the relationship of a patient to the primary insured person.
    Binding: CDARoleCode (example)
    Constraints: should-code-attr
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @code 0..1 cs Binding: Coverage Role Type Value Set . (preferred)
    ....... @codeSystem 0..1 oid, uuid, ruid
    ....... @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
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity This playingEntity records the covered party name and birthTime as represented by the health plan. This could match the information in recordTarget, or be different due to marriage or other reasons.
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... realmCode 0..* CS
    ....... typeId C 0..1 II Constraints: II-1
    ........ @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
    ....... @classCode 0..1 cs Binding: EntityClassRoot (required)
    ....... @determinerCode 0..1 cs Binding: EntityDeterminer (required)
    Fixed Value: INSTANCE
    ....... code 0..1 CE Binding: CDAEntityCode (example)
    ....... quantity 0..* PQ
    ....... name 1..1 PN
    ....... sdtcBirthTime 1..1 TS XML Namespace: urn:hl7-org:sdtc
    sdtc:birthTime
    XML: birthTime (urn:hl7-org:sdtc)
    ....... desc 0..1 ED
    ...... scopingEntity 0..1 Entity
    .... participant:subscriber 0..1 Participant2 When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 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: 2.16.840.1.113883.10.20.22.4.90
    ..... @typeCode 1..1 cs Binding: CDAParticipationType (required)
    Fixed Value: HLD
    ..... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
    Fixed Value: OP
    ..... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
    XML: functionCode (urn:hl7-org:sdtc)
    ..... time 0..1 IVL_TS
    ..... awarenessCode 0..1 CE
    ..... participantRole C 1..1 ParticipantRole Constraints: should-addr
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
    ...... id 1..* II 𝗨𝗦𝗖𝗗𝗜: Subscriber Id: This id is a unique identifier for the subscriber of the coverage (CONF:4537-10120).
    ...... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
    XML: identifiedBy (urn:hl7-org:sdtc)
    ...... code 0..1 CE Binding: CDARoleCode (example)
    ...... addr 0..1 USRealmAddress
    ...... telecom 0..* TEL
    ...... playingDevice 0..1 Device
    ...... playingEntity 0..1 PlayingEntity
    ...... scopingEntity 0..1 Entity
    ... Slices for entryRelationship 0..* EntryRelationship Slice: Unordered, Open by value:act.moodCode
    .... entryRelationship:authorization 0..* EntryRelationship entryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 AuthorizationActivity
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ....... templateId:authorization-activity 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: 2.16.840.1.113883.10.20.1.19
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs EVN
    Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ...... @negationInd 0..1 bl
    ...... id 1..1 II
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    ....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ....... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    ....... @integrityCheck 0..1 bin
    ....... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    ....... @language 0..1 cs
    ....... @mediaType 0..1 cs Binding: MediaType (example)
    ....... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    ....... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    ....... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ....... thumbnail 0..1 ED
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... Slices for entryRelationship 1..* EntryRelationship Slice: Unordered, Open by value:typeCode
    ....... entryRelationship:target C 1..* EntryRelationship The target of an authorization activity MAY contain one or more performer, to indicate the providers that have been authorized to provide treatment (CONF:81-8952).
    Constraints: 81-8951
    ........ @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ........ realmCode 0..* CS
    ........ typeId C 0..1 II Constraints: II-1
    ......... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SUBJ
    ........ @inversionInd 0..1 bl
    ........ @contextConductionInd 0..1 bl
    ........ @negationInd 0..1 bl
    ........ sequenceNumber 0..1 INT
    ........ seperatableInd 0..1 BL
    ........ act 0..1 Act
    ........ 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
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    .... entryRelationship:plan 0..* EntryRelationship Represents the Coverage Plan
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 Act
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... realmCode 0..* CS
    ...... typeId C 0..1 II Constraints: II-1
    ....... @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
    ...... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ...... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: DEF
    ...... @negationInd 0..1 bl
    ...... id 1..* II Plan identifier
    ...... code 1..1 CD Binding: v3 Code System ActCode (example)
    ...... text 1..1 ED Name of the plan
    ...... statusCode 0..1 CS Binding: ActStatus (required)
    ...... effectiveTime 0..1 IVL_TS
    ...... priorityCode 0..1 CE Binding: ActPriority (example)
    ...... languageCode 0..1 CS Binding: AllLanguages (required)
    ...... subject 0..1 Subject
    ...... specimen 0..* Specimen
    ...... performer 0..* Performer2
    ...... author 0..* Author
    ...... informant 0..* Informant
    ...... participant 0..* Participant2
    ...... entryRelationship 0..* EntryRelationship
    ...... reference 0..* Reference
    ...... precondition 0..* Precondition
    ...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
    ..... 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
    ... reference 0..* Reference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.templateId:policy-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base preferred Payer Type . 📦20250419 VSAC v0.23
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.statusCode.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.performer:payer.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.code.​code Base preferred Financially Responsible Party Type Value Set . 📦20240606 VSAC v0.23
    Act.performer:payer.​assignedEntity.representedOrganization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:payer.​assignedEntity.representedOrganization.​classCode Base required EntityClassOrganization 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.performer:payer.​assignedEntity.representedOrganization.​standardIndustryClassCode Base example OrganizationIndustryClassNAICS 📦3.0.0 THO v6.5
    Act.performer:guarantor.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​typeCode Base required ParticipationPhysicalPerformer 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.classCode Base required RoleClassAssignedEntity 📦3.0.0 THO v6.5
    Act.performer:guarantor.​assignedEntity.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.performer:guarantor.​assignedEntity.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​time.operator Base required CDASetOperator 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.code.​code Base preferred Coverage Role Type Value Set . 📦20240607 VSAC v0.23
    Act.participant:coverage-target.​participantRole.playingEntity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:coverage-target.​participantRole.playingEntity.​classCode Base required EntityClassRoot 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​determinerCode Base required EntityDeterminer 📦3.0.0 THO v6.5
    Act.participant:coverage-target.​participantRole.playingEntity.​code Base example CDAEntityCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​templateId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​typeCode Base required CDAParticipationType 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​contextControlCode Base required CDAContextControl 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.classCode Base required CDARoleClassRoot 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.participant:subscriber.​participantRole.code Base example CDARoleCode 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.templateId:authorization-activity.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.compression Base required CDACompressionAlgorithm 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.entryRelationship:authorization.​act.text.mediaType Base example MediaType 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.text.representation Base required CDABinaryDataEncoding 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:authorization.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:authorization.​act.entryRelationship:target.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:authorization.​act.entryRelationship:target.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.1-sd Clinical Document Architecture v2.0
    Act.entryRelationship:plan.​act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.entryRelationship:plan.​act.code Base example v3 Code System ActCode 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.statusCode Base required ActStatus 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.priorityCode Base example ActPriority 📦3.0.0 THO v6.5
    Act.entryRelationship:plan.​act.languageCode Base required All Languages 📦5.0.0 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    4537-8967 warning Act.performer:guarantor.assignedEntity **SHOULD** include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name (CONF:4537-8967). assignedPerson.name.exists() or representedOrganization.name.exists()
    4537-17139 error Act When the Subscriber is the patient (COV participant code = 'SELF'), the participant element describing the subscriber **SHALL NOT** be present. This information will be recorded instead in the data elements used to record member information (CONF:4537-17139). participant.where(typeCode='COV').participantRole.code.where(code = 'SELF').exists() implies participant.where(typeCode='HLD').empty()
    81-8951 error Act.entryRelationship:authorization.act.entryRelationship:target The target of an authorization activity with act/entryRelationship/@typeCode="SUBJ" SHALL be a clinical statement with moodCode="PRMS" Promise (CONF:81-8951). (act | encounter | observation | observationMedia | organizer | procedure | regionOfInterest | substanceAdministration | supply).where(moodCode='PRMS').exists()
    II-1 error Act.typeId, Act.performer:payer.typeId, Act.performer:payer.assignedEntity.typeId, Act.performer:payer.assignedEntity.representedOrganization.typeId, Act.performer:guarantor.typeId, Act.performer:guarantor.assignedEntity.typeId, Act.participant:coverage-target.typeId, Act.participant:coverage-target.participantRole.typeId, Act.participant:coverage-target.participantRole.playingEntity.typeId, Act.participant:subscriber.typeId, Act.participant:subscriber.participantRole.typeId, Act.entryRelationship:authorization.typeId, Act.entryRelationship:authorization.act.typeId, Act.entryRelationship:authorization.act.entryRelationship:target.typeId, Act.entryRelationship:plan.typeId, Act.entryRelationship:plan.act.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-addr warning Act.performer:guarantor.assignedEntity, Act.participant:coverage-target.participantRole, Act.participant:subscriber.participantRole SHOULD contain addr addr.exists()
    should-code warning Act.performer:payer.assignedEntity SHOULD contain code code.exists()
    should-code-attr warning Act.participant:coverage-target.participantRole.code SHOULD contain @code code.exists()
    should-high warning Act.participant:coverage-target.time SHOULD contain high high.exists()
    should-low warning Act.participant:coverage-target.time SHOULD contain low low.exists()
    should-name warning Act.performer:payer.assignedEntity.representedOrganization SHOULD contain name name.exists()
    should-playingEntity warning Act.participant:coverage-target.participantRole SHOULD contain playingEntity playingEntity.exists()
    should-representedOrganization warning Act.performer:payer.assignedEntity SHOULD contain representedOrganization representedOrganization.exists()
    should-telecom warning Act.performer:guarantor.assignedEntity SHOULD contain telecom telecom.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    should-time warning Act.performer:guarantor, Act.participant:coverage-target SHOULD contain time time.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    value-starts-octothorpe error Act.entryRelationship:authorization.act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    This structure is derived from Act

    Summary

    Mandatory: 18 elements(16 nested mandatory elements)
    Fixed: 9 elements
    Prohibited: 5 elements

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 2 is sliced based on the values of Act.templateId
    • The element 1 is sliced based on the value of Act.performer
    • The element 1 is sliced based on the value of Act.participant
    • The element 1 is sliced based on the value of Act.entryRelationship

     

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