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:
Preoperative Diagnosis Section
Official URL : http://hl7.org/cda/us/ccda/StructureDefinition/PreoperativeDiagnosisSection
Version :
4.0.0
Draft
as of 2025-06-16
Computable Name : PreoperativeDiagnosisSection
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.2.34:2015-08-01
The Preoperative Diagnosis Section records the surgical diagnoses assigned to the patient before the surgical procedure which are the reason for the surgery. The preoperative diagnosis is, in the surgeon's opinion, the diagnosis that will be confirmed during surgery.
Templates Used
Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:
Recommended Entries : PreoperativeDiagnosis
Usages:
Changes since version 3.0.0:
The resource metadata has changed (description)
Formal Views of Template Content
Description of Template, Differentials, Snapshots and how the different presentations work .
This structure is derived from Section
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1 .. 1 Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx Slices for templateId 1 .. * II Slice: Unordered, Open by value:root, value:extension templateId:section 1..1
II @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 code 1..1
CE Surgical operation note preoperative diagnosis Narrative @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 title 1..1
ST text 1..1
xhtml Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry act 1..1
PreoperativeDiagnosis
Constraints
Id Grade Path(s) Details Requirements should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1..1
Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx @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, value:extension templateId:section 1..1
II @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @assigningAuthorityName 0..1
st @displayable 0..1
bl @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 @ID 0..1
xs:ID @classCode 0..1
cs Binding: ActClassRecordOrganizer ( required ) Fixed Value: DOCSECT @moodCode 0..1
cs Binding: CDAActMood ( required ) Fixed Value: EVN id 0..1
II code 1..1
CE Surgical operation note preoperative diagnosis Narrative @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 @codeSystemName 0..1
st @codeSystemVersion 0..1
st @displayName 0..1
st @sdtcValueSet 0..1
oid XML Namespace: urn:hl7-org:sdtcXML: valueSet (urn:hl7-org:sdtc)@sdtcValueSetVersion 0..1
st XML Namespace: urn:hl7-org:sdtcXML: valueSetVersion (urn:hl7-org:sdtc)originalText 0..1
ED translation 0..*
CD title 1..1
ST text 1..1
xhtml confidentialityCode 0..1
CE languageCode 0..1
CS Binding: AllLanguages ( required ) subject 0..1
Subject author 0..*
Author informant 0..*
Informant Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry @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 0..1
cs Binding: x_ActRelationshipEntry ( required ) @contextConductionInd 0..1
bl Fixed Value: true act 1..1
PreoperativeDiagnosis encounter 0..1
Encounter observation 0..1
Observation observationMedia 0..1
ObservationMedia organizer 0..1
Organizer procedure 0..1
Procedure regionOfInterest 0..1
RegionOfInterest substanceAdministration 0..1
SubstanceAdministration supply 0..1
Supply component 0..*
InfrastructureRoot @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) realmCode 0..*
CS typeId C 0..1
II 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 0..1
cs Fixed Value: COMP @contextConductionInd 0..1
bl Fixed Value: true section 1..1
Section
Terminology Bindings
Path Conformance ValueSet / Code URI Section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode required Fixed Value: DOCSECThttp://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode required Fixed Value: EVNhttp://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode required AllLanguages http://hl7.org/fhir/ValueSet/all-languages
From the FHIR Standard
Section.entry:preopDiagnosis.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeCode required XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Constraints
Id Grade Path(s) Details Requirements II-1 error Section.typeId, Section.entry:preopDiagnosis.typeId, Section.component.typeId An II instance must have either a root or an nullFlavor. should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1..1
Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx @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, value:extension templateId:section 1..1
II @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @assigningAuthorityName 0..1
st @displayable 0..1
bl @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 @ID 0..1
xs:ID @classCode 0..1
cs Binding: ActClassRecordOrganizer ( required ) Fixed Value: DOCSECT @moodCode 0..1
cs Binding: CDAActMood ( required ) Fixed Value: EVN id 0..1
II code 1..1
CE Surgical operation note preoperative diagnosis Narrative @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 @codeSystemName 0..1
st @codeSystemVersion 0..1
st @displayName 0..1
st @sdtcValueSet 0..1
oid XML Namespace: urn:hl7-org:sdtcXML: valueSet (urn:hl7-org:sdtc)@sdtcValueSetVersion 0..1
st XML Namespace: urn:hl7-org:sdtcXML: valueSetVersion (urn:hl7-org:sdtc)originalText 0..1
ED translation 0..*
CD title 1..1
ST text 1..1
xhtml confidentialityCode 0..1
CE languageCode 0..1
CS Binding: AllLanguages ( required ) subject 0..1
Subject author 0..*
Author informant 0..*
Informant Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry @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 0..1
cs Binding: x_ActRelationshipEntry ( required ) @contextConductionInd 0..1
bl Fixed Value: true act 1..1
PreoperativeDiagnosis encounter 0..1
Encounter observation 0..1
Observation observationMedia 0..1
ObservationMedia organizer 0..1
Organizer procedure 0..1
Procedure regionOfInterest 0..1
RegionOfInterest substanceAdministration 0..1
SubstanceAdministration supply 0..1
Supply component 0..*
InfrastructureRoot @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) realmCode 0..*
CS typeId C 0..1
II 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 0..1
cs Fixed Value: COMP @contextConductionInd 0..1
bl Fixed Value: true section 1..1
Section
Terminology Bindings
Path Conformance ValueSet / Code URI Section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode required Fixed Value: DOCSECThttp://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode required Fixed Value: EVNhttp://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode required AllLanguages http://hl7.org/fhir/ValueSet/all-languages
From the FHIR Standard
Section.entry:preopDiagnosis.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeCode required XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Constraints
Id Grade Path(s) Details Requirements II-1 error Section.typeId, Section.entry:preopDiagnosis.typeId, Section.component.typeId An II instance must have either a root or an nullFlavor. should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
This structure is derived from Section
Summary
Mandatory: 9 elements(1 nested mandatory element)
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 Section.templateId
The element 1 is sliced based on the value of Section.entry
Differential View
This structure is derived from Section
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1 .. 1 Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx Slices for templateId 1 .. * II Slice: Unordered, Open by value:root, value:extension templateId:section 1..1
II @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 code 1..1
CE Surgical operation note preoperative diagnosis Narrative @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 title 1..1
ST text 1..1
xhtml Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry act 1..1
PreoperativeDiagnosis
Constraints
Id Grade Path(s) Details Requirements should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
Key Elements View
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1..1
Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx @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, value:extension templateId:section 1..1
II @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @assigningAuthorityName 0..1
st @displayable 0..1
bl @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 @ID 0..1
xs:ID @classCode 0..1
cs Binding: ActClassRecordOrganizer ( required ) Fixed Value: DOCSECT @moodCode 0..1
cs Binding: CDAActMood ( required ) Fixed Value: EVN id 0..1
II code 1..1
CE Surgical operation note preoperative diagnosis Narrative @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 @codeSystemName 0..1
st @codeSystemVersion 0..1
st @displayName 0..1
st @sdtcValueSet 0..1
oid XML Namespace: urn:hl7-org:sdtcXML: valueSet (urn:hl7-org:sdtc)@sdtcValueSetVersion 0..1
st XML Namespace: urn:hl7-org:sdtcXML: valueSetVersion (urn:hl7-org:sdtc)originalText 0..1
ED translation 0..*
CD title 1..1
ST text 1..1
xhtml confidentialityCode 0..1
CE languageCode 0..1
CS Binding: AllLanguages ( required ) subject 0..1
Subject author 0..*
Author informant 0..*
Informant Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry @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 0..1
cs Binding: x_ActRelationshipEntry ( required ) @contextConductionInd 0..1
bl Fixed Value: true act 1..1
PreoperativeDiagnosis encounter 0..1
Encounter observation 0..1
Observation observationMedia 0..1
ObservationMedia organizer 0..1
Organizer procedure 0..1
Procedure regionOfInterest 0..1
RegionOfInterest substanceAdministration 0..1
SubstanceAdministration supply 0..1
Supply component 0..*
InfrastructureRoot @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) realmCode 0..*
CS typeId C 0..1
II 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 0..1
cs Fixed Value: COMP @contextConductionInd 0..1
bl Fixed Value: true section 1..1
Section
Terminology Bindings
Path Conformance ValueSet / Code URI Section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode required Fixed Value: DOCSECThttp://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode required Fixed Value: EVNhttp://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode required AllLanguages http://hl7.org/fhir/ValueSet/all-languages
From the FHIR Standard
Section.entry:preopDiagnosis.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeCode required XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Constraints
Id Grade Path(s) Details Requirements II-1 error Section.typeId, Section.entry:preopDiagnosis.typeId, Section.component.typeId An II instance must have either a root or an nullFlavor. should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
Snapshot View
Name Flags Card. Type Description & Constraints Filter: Bindings
Section C 1..1
Section XML Namespace: urn:hl7-org:v3@nullFlavor , realmCode , typeId , templateId , @ID , @classCode , @moodCode , id , code , title , text , confidentialityCode , languageCode , subject , author , informant , entry , component Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-preop-dx @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, value:extension templateId:section 1..1
II @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @assigningAuthorityName 0..1
st @displayable 0..1
bl @root 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.34 @extension 1..1
st Required Pattern: 2015-08-01 @ID 0..1
xs:ID @classCode 0..1
cs Binding: ActClassRecordOrganizer ( required ) Fixed Value: DOCSECT @moodCode 0..1
cs Binding: CDAActMood ( required ) Fixed Value: EVN id 0..1
II code 1..1
CE Surgical operation note preoperative diagnosis Narrative @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) @code 1..1
cs Required Pattern: 10219-4 @codeSystem 1..1
oid , uuid , ruid Required Pattern: 2.16.840.1.113883.6.1 @codeSystemName 0..1
st @codeSystemVersion 0..1
st @displayName 0..1
st @sdtcValueSet 0..1
oid XML Namespace: urn:hl7-org:sdtcXML: valueSet (urn:hl7-org:sdtc)@sdtcValueSetVersion 0..1
st XML Namespace: urn:hl7-org:sdtcXML: valueSetVersion (urn:hl7-org:sdtc)originalText 0..1
ED translation 0..*
CD title 1..1
ST text 1..1
xhtml confidentialityCode 0..1
CE languageCode 0..1
CS Binding: AllLanguages ( required ) subject 0..1
Subject author 0..*
Author informant 0..*
Informant Slices for entry 0 .. * Entry Slice: Unordered, Open by profile:act entry:preopDiagnosis 0..1
Entry @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 0..1
cs Binding: x_ActRelationshipEntry ( required ) @contextConductionInd 0..1
bl Fixed Value: true act 1..1
PreoperativeDiagnosis encounter 0..1
Encounter observation 0..1
Observation observationMedia 0..1
ObservationMedia organizer 0..1
Organizer procedure 0..1
Procedure regionOfInterest 0..1
RegionOfInterest substanceAdministration 0..1
SubstanceAdministration supply 0..1
Supply component 0..*
InfrastructureRoot @nullFlavor 0..1
cs Binding: CDANullFlavor ( required ) realmCode 0..*
CS typeId C 0..1
II 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 0..1
cs Fixed Value: COMP @contextConductionInd 0..1
bl Fixed Value: true section 1..1
Section
Terminology Bindings
Path Conformance ValueSet / Code URI Section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.templateId:section.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.classCode required Fixed Value: DOCSECThttp://terminology.hl7.org/ValueSet/v3-ActClassRecordOrganizer
Section.moodCode required Fixed Value: EVNhttp://hl7.org/cda/stds/core/ValueSet/CDAActMood
Section.code.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.languageCode required AllLanguages http://hl7.org/fhir/ValueSet/all-languages
From the FHIR Standard
Section.entry:preopDiagnosis.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.entry:preopDiagnosis.typeCode required XActRelationshipEntry http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry
Section.component.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Section.component.typeId.nullFlavor required CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Constraints
Id Grade Path(s) Details Requirements II-1 error Section.typeId, Section.entry:preopDiagnosis.typeId, Section.component.typeId An II instance must have either a root or an nullFlavor. should-preop-dx warning Section SHOULD contain Preoperative Diagnosis
This structure is derived from Section
Summary
Mandatory: 9 elements(1 nested mandatory element)
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 Section.templateId
The element 1 is sliced based on the value of Section.entry
Other representations of profile: CSV , Excel
Section 
Slices for templateId 
templateId:section 
@extension 
act 
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