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
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ProblemStatus | Version: 4.0.0 | |||
| Draft as of 2025-10-31 | Computable Name: ProblemStatus | |||
| Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.6:2019-06-20 | ||||
The Problem Status records the clinical status attributed to the problem.
Usages:
You can also check for usages in the FHIR IG Statistics
Changes since version 3.0.0:
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Fixed Value: OBS | |
![]() ![]()  | 
1..1 | cs | Fixed Value: EVN | |
![]() ![]()  | 
1..1 | CD | Diagnosis status | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]()  | 
1..1 | CS | ||
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Id | Grade | Path(s) | Description | Expression | 
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
      value.exists() implies value.startsWith('#')
     | 
  
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]()  | 
0..* | CS | ||
![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS  | |
![]() ![]()  | 
1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN  | |
![]() ![]()  | 
0..1 | bl | ||
![]() ![]()  | 
0..* | II | ||
![]() ![]()  | 
0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
1..1 | CD | Diagnosis status Binding: ObservationType (example)  | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]() ![]()  | 
0..* | CR | ||
![]() ![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | ST | ||
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
![]() ![]() ![]()  | 
0..1 | bin | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
![]() ![]() ![]()  | 
0..1 | cs | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: MediaType (example) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
![]() ![]() ![]()  | 
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]()  | 
1..1 | CS | Binding: ActStatus (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..1 | IVL_TS | ||
![]() ![]()  | 
0..1 | CE | Binding: ActPriority (example) | |
![]() ![]()  | 
0..1 | IVL_INT | ||
![]() ![]()  | 
0..1 | CS | Binding: AllLanguages (required) | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
![]() ![]()  | 
0..* | CE | Binding: CDAObservationInterpretation (required) | |
![]() ![]()  | 
0..* | CE | Binding: ObservationMethod (example) | |
![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | Subject | ||
![]() ![]()  | 
0..* | Specimen | ||
![]() ![]()  | 
0..* | Performer2 | ||
![]() ![]()  | 
0..* | Author | ||
![]() ![]()  | 
0..* | Informant | ||
![]() ![]()  | 
0..* | Participant2 | ||
![]() ![]()  | 
0..* | EntryRelationship | ||
![]() ![]()  | 
0..* | Reference | ||
![]() ![]()  | 
0..* | Precondition | ||
![]() ![]()  | 
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..* | InfrastructureRoot | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..* | CS | ||
![]() ![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]() ![]()  | 
0..* | II | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV  | |
![]() ![]() ![]()  | 
1..1 | ObservationRange | ||
![]() ![]()  | 
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)  | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.templateId:problem-status.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2 | 
| Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5 | 
| Observation.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 | 
| Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5 | 
| Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5 | 
| Observation.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5 | 
| Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5 | 
| Observation.referenceRange.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Id | Grade | Path(s) | Description | Expression | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | 
      root.exists() or nullFlavor.exists()
     | 
  
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
      value.exists() implies value.startsWith('#')
     | 
  
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]()  | 
0..* | CS | ||
![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS  | |
![]() ![]()  | 
1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN  | |
![]() ![]()  | 
0..1 | bl | ||
![]() ![]()  | 
0..* | II | ||
![]() ![]()  | 
0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
1..1 | CD | Diagnosis status Binding: ObservationType (example)  | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]() ![]()  | 
0..* | CR | ||
![]() ![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | ST | ||
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
![]() ![]() ![]()  | 
0..1 | bin | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
![]() ![]() ![]()  | 
0..1 | cs | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: MediaType (example) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
![]() ![]() ![]()  | 
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]()  | 
1..1 | CS | Binding: ActStatus (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..1 | IVL_TS | ||
![]() ![]()  | 
0..1 | CE | Binding: ActPriority (example) | |
![]() ![]()  | 
0..1 | IVL_INT | ||
![]() ![]()  | 
0..1 | CS | Binding: AllLanguages (required) | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
![]() ![]()  | 
0..* | CE | Binding: CDAObservationInterpretation (required) | |
![]() ![]()  | 
0..* | CE | Binding: ObservationMethod (example) | |
![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | Subject | ||
![]() ![]()  | 
0..* | Specimen | ||
![]() ![]()  | 
0..* | Performer2 | ||
![]() ![]()  | 
0..* | Author | ||
![]() ![]()  | 
0..* | Informant | ||
![]() ![]()  | 
0..* | Participant2 | ||
![]() ![]()  | 
0..* | EntryRelationship | ||
![]() ![]()  | 
0..* | Reference | ||
![]() ![]()  | 
0..* | Precondition | ||
![]() ![]()  | 
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..* | InfrastructureRoot | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..* | CS | ||
![]() ![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]() ![]()  | 
0..* | II | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV  | |
![]() ![]() ![]()  | 
1..1 | ObservationRange | ||
![]() ![]()  | 
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)  | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.templateId:problem-status.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2 | 
| Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5 | 
| Observation.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 | 
| Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5 | 
| Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5 | 
| Observation.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5 | 
| Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5 | 
| Observation.referenceRange.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Id | Grade | Path(s) | Description | Expression | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | 
      root.exists() or nullFlavor.exists()
     | 
  
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.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 Observation
Summary
Mandatory: 9 elements
 Fixed: 3 elements
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Fixed Value: OBS | |
![]() ![]()  | 
1..1 | cs | Fixed Value: EVN | |
![]() ![]()  | 
1..1 | CD | Diagnosis status | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]()  | 
1..1 | CS | ||
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Id | Grade | Path(s) | Description | Expression | 
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.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
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]()  | 
0..* | CS | ||
![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS  | |
![]() ![]()  | 
1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN  | |
![]() ![]()  | 
0..1 | bl | ||
![]() ![]()  | 
0..* | II | ||
![]() ![]()  | 
0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
1..1 | CD | Diagnosis status Binding: ObservationType (example)  | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]() ![]()  | 
0..* | CR | ||
![]() ![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | ST | ||
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
![]() ![]() ![]()  | 
0..1 | bin | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
![]() ![]() ![]()  | 
0..1 | cs | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: MediaType (example) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
![]() ![]() ![]()  | 
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]()  | 
1..1 | CS | Binding: ActStatus (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..1 | IVL_TS | ||
![]() ![]()  | 
0..1 | CE | Binding: ActPriority (example) | |
![]() ![]()  | 
0..1 | IVL_INT | ||
![]() ![]()  | 
0..1 | CS | Binding: AllLanguages (required) | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
![]() ![]()  | 
0..* | CE | Binding: CDAObservationInterpretation (required) | |
![]() ![]()  | 
0..* | CE | Binding: ObservationMethod (example) | |
![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | Subject | ||
![]() ![]()  | 
0..* | Specimen | ||
![]() ![]()  | 
0..* | Performer2 | ||
![]() ![]()  | 
0..* | Author | ||
![]() ![]()  | 
0..* | Informant | ||
![]() ![]()  | 
0..* | Participant2 | ||
![]() ![]()  | 
0..* | EntryRelationship | ||
![]() ![]()  | 
0..* | Reference | ||
![]() ![]()  | 
0..* | Precondition | ||
![]() ![]()  | 
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..* | InfrastructureRoot | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..* | CS | ||
![]() ![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]() ![]()  | 
0..* | II | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV  | |
![]() ![]() ![]()  | 
1..1 | ObservationRange | ||
![]() ![]()  | 
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)  | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.templateId:problem-status.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2 | 
| Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5 | 
| Observation.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 | 
| Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5 | 
| Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5 | 
| Observation.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5 | 
| Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5 | 
| Observation.referenceRange.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Id | Grade | Path(s) | Description | Expression | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | 
      root.exists() or nullFlavor.exists()
     | 
  
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.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
| Name | Flags | Card. | Type | Description & Constraints    Filter:  ![]() ![]()  | 
|---|---|---|---|---|
![]()  | 
C | 1..1 | Observation | 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  | 
![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]()  | 
0..* | CS | ||
![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]()  | 
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]()  | 
1..1 | II | ||
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.6 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | Required Pattern: 2019-06-20 | |
![]() ![]()  | 
1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS  | |
![]() ![]()  | 
1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN  | |
![]() ![]()  | 
0..1 | bl | ||
![]() ![]()  | 
0..* | II | ||
![]() ![]()  | 
0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
1..1 | CD | Diagnosis status Binding: ObservationType (example)  | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Required Pattern: 33999-4 | |
![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1  | |
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]() ![]()  | 
0..* | CR | ||
![]() ![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | ST | ||
![]() ![]()  | 
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
![]() ![]() ![]()  | 
0..1 | bin | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
![]() ![]() ![]()  | 
0..1 | cs | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: MediaType (example) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
![]() ![]() ![]()  | 
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
![]() ![]() ![]()  | 
C | 0..1 | TEL | Constraints: value-starts-octothorpe | 
![]() ![]() ![]()  | 
0..1 | ED | ||
![]() ![]()  | 
1..1 | CS | Binding: ActStatus (required) | |
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
1..1 | cs | Fixed Value: completed | |
![]() ![]() ![]()  | 
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)  | |
![]() ![]() ![]()  | 
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..1 | IVL_TS | ||
![]() ![]()  | 
0..1 | CE | Binding: ActPriority (example) | |
![]() ![]()  | 
0..1 | IVL_INT | ||
![]() ![]()  | 
0..1 | CS | Binding: AllLanguages (required) | |
![]() ![]()  | 
1..1 | CD | Binding: Problem Status   (required) | |
![]() ![]()  | 
0..* | CE | Binding: CDAObservationInterpretation (required) | |
![]() ![]()  | 
0..* | CE | Binding: ObservationMethod (example) | |
![]() ![]()  | 
0..* | CD | ||
![]() ![]()  | 
0..1 | Subject | ||
![]() ![]()  | 
0..* | Specimen | ||
![]() ![]()  | 
0..* | Performer2 | ||
![]() ![]()  | 
0..* | Author | ||
![]() ![]()  | 
0..* | Informant | ||
![]() ![]()  | 
0..* | Participant2 | ||
![]() ![]()  | 
0..* | EntryRelationship | ||
![]() ![]()  | 
0..* | Reference | ||
![]() ![]()  | 
0..* | Precondition | ||
![]() ![]()  | 
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)  | |
![]() ![]()  | 
0..* | InfrastructureRoot | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]()  | 
0..* | CS | ||
![]() ![]() ![]()  | 
C | 0..1 | II | Constraints: II-1 | 
![]() ![]() ![]() ![]()  | 
0..1 | cs | Binding: CDANullFlavor (required) | |
![]() ![]() ![]() ![]()  | 
0..1 | st | ||
![]() ![]() ![]() ![]()  | 
0..1 | bl | ||
![]() ![]() ![]() ![]()  | 
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
![]() ![]() ![]() ![]()  | 
1..1 | st | ||
![]() ![]() ![]()  | 
0..* | II | ||
![]() ![]() ![]()  | 
0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV  | |
![]() ![]() ![]()  | 
1..1 | ObservationRange | ||
![]() ![]()  | 
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)  | |
  Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source | 
| Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.templateId:problem-status.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2 | 
| Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5 | 
| Observation.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 | 
| Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5 | 
| Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5 | 
| Observation.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5 | 
| Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. | 
| Observation.value | Base | required | 
      Problem Status
      
       
     | 
    📦20240606 | VSAC v0.23 | 
| Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5 | 
| Observation.referenceRange.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Observation.referenceRange.typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0 | 
| Id | Grade | Path(s) | Description | Expression | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | 
      root.exists() or nullFlavor.exists()
     | 
  
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | 
      text.reference.value.exists()
     | 
  
| value-starts-octothorpe | error | Observation.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 Observation
Summary
Mandatory: 9 elements
 Fixed: 3 elements
Slices
This structure defines the following Slices: