Consolidated CDA (C-CDA)
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Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

Logical Model: ReferralAct - Detailed Descriptions

Draft as of 2025-12-03

Definitions for the ReferralAct logical model.

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

0. Act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


Base definition for all types defined in FHIR type system.

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

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

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

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

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

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

Identifies the type as an HL7 Registered model

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

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

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

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

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

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

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

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

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.10.20.22.4.140
    30. Act.templateId:referral-act.extension
    Definition

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

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    32. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="PCPR" provision of care (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-30884).

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

    SHALL contain exactly one [1..1] @moodCode, which SHALL be selected from ValueSet Referral Act moodCode urn:oid:2.16.840.1.113883.11.20.9.66 STATIC 2014-09-01 (CONF:1098-30885).

    Control1..1
    BindingThe codes SHALL be taken from Patient Referral Act moodCode .
    (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    36. Act.negationInd
    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    38. Act.id
    ShortIn the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
    Comments

    SHALL contain at least one [1..*] id (CONF:1098-30888).

    Control1..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    40. Act.code
    Comments

    SHALL contain exactly one [1..1] code, which SHALL be selected from ValueSet Referral Types urn:oid:2.16.840.1.113883.11.20.9.56 DYNAMIC (CONF:1098-30889).

    Control1..1
    BindingThe codes SHALL be taken from Referral Types .
    (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    42. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    Control0..1
    This element is affected by the following invariants: should-text-ref-value
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    44. Act.text.nullFlavor
    Definition

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

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

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

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

    The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

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

    Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

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

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

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

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

    Control0..1
    BindingFor example codes, see MediaType
    (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelMedia Type
    56. Act.text.representation
    Control0..1
    BindingThe codes SHALL be taken from CDABinaryDataEncoding
    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    58. Act.text.xmlText
    Definition

    Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

    ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    Comments

    This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

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

    A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    LabelReference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    62. Act.text.thumbnail
    Definition

    An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelThumbnail
    InvariantsED-1: Thumbnails cannot contain their own thumbnails (thumbnail.empty())
    64. Act.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:1098-30892).

    Control1..1
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    66. Act.statusCode.nullFlavor
    Definition

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

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

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    Control1..1
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    70. Act.statusCode.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..0
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    72. Act.statusCode.codeSystemName
    Definition

    The common name of the coding system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    74. Act.statusCode.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    76. Act.statusCode.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    78. Act.statusCode.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    80. Act.statusCode.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    82. Act.statusCode.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    84. Act.statusCode.qualifier
    Definition

    Specifies additional codes that increase the specificity of the the primary code.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    86. Act.statusCode.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    88. Act.effectiveTime
    ShortThe effectiveTime represents the time when the future referral is intended to take place.
    Comments

    SHALL contain exactly one [1..1] effectiveTime (CONF:1098-30893).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
    90. Act.priorityCode
    Shorticon Added:SHOULD contain priorityCode
    Comments

    SHOULD contain zero or one [0..1] priorityCode (CONF:1098-32623).

    Control0..1
    This element is affected by the following invariants: should-priorityCode
    BindingFor example codes, see ActPriority
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    92. Act.languageCode
    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    94. Act.subject
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
    96. Act.specimen
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
    98. Act.performer
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
    100. Act.author
    Shorticon Added:SHOULD contain author
    Comments

    SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1098-31612).

    Control0..*
    This element is affected by the following invariants: should-author
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
    102. Act.informant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
    104. Act.participant
    Comments

    MAY contain zero or more [0..*] participant (CONF:1098-32635).

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
    106. Act.participant.nullFlavor
    Definition

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

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

    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    110. Act.participant.typeId
    Definition

    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

    Identifies the type as an HL7 Registered model

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

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

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

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

    The participant, if present, SHALL contain exactly one [1..1] @typeCode. Use REFT to represent the referred-to provider.

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

    The participant, if present, SHALL contain exactly one [1..1] participantRole (CONF:1098-32636).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
    136. Act.participant.participantRole.nullFlavor
    Definition

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

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

    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    140. Act.participant.participantRole.typeId
    Definition

    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

    Identifies the type as an HL7 Registered model

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

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

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

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    154. Act.participant.participantRole.classCode
    Control0..1
    BindingThe codes SHALL be taken from CDARoleClassRoot
    (required to http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Default ValueROL
    156. Act.participant.participantRole.id
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    158. Act.participant.participantRole.sdtcIdentifiedBy
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameidentifiedBy.
    160. Act.participant.participantRole.code
    Comments

    This participantRole MAY contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1098-32637).

    Control0..1
    BindingThe codes SHOULD be taken from Healthcare Provider Taxonomy .
    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    162. Act.participant.participantRole.sdtcSpecialty
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namespecialty.
    164. Act.participant.participantRole.addr
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD
    166. Act.participant.participantRole.telecom
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    168. Act.participant.participantRole.playingDevice
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Device
    170. Act.participant.participantRole.playingEntity
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
    172. Act.participant.participantRole.scopingEntity
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Entity
    174. Act.entryRelationship
    ShortThe following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
    SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ observation
    • 176. Act.entryRelationship:careModel
      Slice NamecareModel
      ShortThe following entryRelationship represents whether the referral is for full or shared care.
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:1098-31604) such that it

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      178. Act.entryRelationship:careModel.nullFlavor
      Definition

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

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

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      182. Act.entryRelationship:careModel.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

      Identifies the type as an HL7 Registered model

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

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

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

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

      SHALL contain exactly one [1..1] @typeCode="SUBJ" has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31613).

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

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

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

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      202. Act.entryRelationship:careModel.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      204. Act.entryRelationship:careModel.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      206. Act.entryRelationship:careModel.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      208. Act.entryRelationship:careModel.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      210. Act.entryRelationship:careModel.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      212. Act.entryRelationship:careModel.observation
      Comments

      SHALL contain exactly one [1..1] observation (CONF:1098-31605).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
      Invariantsshould-priorityCode: SHOULD contain priorityCode (priorityCode.exists())
      214. Act.entryRelationship:careModel.observation.nullFlavor
      Definition

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

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

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      218. Act.entryRelationship:careModel.observation.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

      Identifies the type as an HL7 Registered model

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

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

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

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      232. Act.entryRelationship:careModel.observation.classCode
      Comments

      This observation SHALL contain exactly one [1..1] @classCode="OBS" observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31606).

      Control1..1
      BindingThe codes SHALL be taken from CDAActClassObservation
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueOBS
      234. Act.entryRelationship:careModel.observation.moodCode
      Comments

      This observation SHALL contain exactly one [1..1] @moodCode="RQO" request (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31607).

      Control1..1
      BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
      (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueRQO
      236. Act.entryRelationship:careModel.observation.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      238. Act.entryRelationship:careModel.observation.id
      Definition

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

      ShortLogical id of this artifact
      Comments

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..*1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
      Is Modifierfalse
      240. Act.entryRelationship:careModel.observation.sdtcCategory
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
      242. Act.entryRelationship:careModel.observation.code
      Definition

      Describes what was observed. Sometimes this is called the observation "name".

      ShortType of observation (code / type)
      Comments

      This observation SHALL contain exactly one [1..1] code (CONF:1098-31608).


      All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

      Control1..1
      This element is affected by the following invariants: obs-7
      BindingFor example codes, see ObservationTypehttp://hl7.org/fhir/ValueSet/observation-codes|5.0.0
      (example to http://terminology.hl7.org/ValueSet/v3-ObservationType)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
      Is Modifierfalse
      XML FormatThe type of this property is determined using the xsi:typeattribute.
      Requirements

      Knowing what kind of observation is being made is essential to understanding the observation.

      Alternate NamesName
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      244. Act.entryRelationship:careModel.observation.code.nullFlavor
      Definition

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

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

      The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

      Comments

      This code SHALL contain exactly one [1..1] @code="ASSERTION" assertion (CONF:1098-31619).

      Control1..1
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode
      Pattern ValueASSERTION
      248. Act.entryRelationship:careModel.observation.code.codeSystem
      Definition

      Specifies the code system that defines the code.

      Comments

      This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.4 " (CodeSystem: HL7ActCode urn:oid:2.16.840.1.113883.5.4) (CONF:1098-31620).

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System
      Pattern Value2.16.840.1.113883.5.4
      250. Act.entryRelationship:careModel.observation.code.codeSystemName
      Definition

      The common name of the coding system.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System Name
      252. Act.entryRelationship:careModel.observation.code.codeSystemVersion
      Definition

      If applicable, a version descriptor defined specifically for the given code system.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System Version
      254. Act.entryRelationship:careModel.observation.code.displayName
      Definition

      A name or title for the code, under which the sending system shows the code value to its users.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplay Name
      256. Act.entryRelationship:careModel.observation.code.sdtcValueSet
      Definition

      The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

      Control0..1
      Typestring(oid: ISO Object Identifier)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
      258. Act.entryRelationship:careModel.observation.code.sdtcValueSetVersion
      Definition

      The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
      260. Act.entryRelationship:careModel.observation.code.originalText
      Definition

      The text or phrase used as the basis for the coding.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
      LabelOriginal Text
      262. Act.entryRelationship:careModel.observation.code.qualifier
      Definition

      Specifies additional codes that increase the specificity of the the primary code.

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
      LabelQualifier
      264. Act.entryRelationship:careModel.observation.code.translation
      Definition

      A set of other concept descriptors that translate this concept descriptor into other code systems.

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatThe type of this property is determined using the xsi:typeattribute.
      LabelTranslation
      266. Act.entryRelationship:careModel.observation.derivationExpr
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
      268. Act.entryRelationship:careModel.observation.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
      Is Modifierfalse
      XML FormatThe type of this property is determined using the xsi:typeattribute.
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      270. Act.entryRelationship:careModel.observation.statusCode
      Comments

      This observation SHALL contain exactly one [1..1] statusCode (CONF:1098-31614).

      Control1..1
      BindingThe codes SHALL be taken from ActStatus
      (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      272. Act.entryRelationship:careModel.observation.statusCode.nullFlavor
      Definition

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

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

      The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

      Comments

      This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:1098-31615).

      Control1..1
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode
      Fixed Valuecompleted
      276. Act.entryRelationship:careModel.observation.statusCode.codeSystem
      Definition

      Specifies the code system that defines the code.

      Control0..0
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System
      278. Act.entryRelationship:careModel.observation.statusCode.codeSystemName
      Definition

      The common name of the coding system.

      Control0..0
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System Name
      280. Act.entryRelationship:careModel.observation.statusCode.codeSystemVersion
      Definition

      If applicable, a version descriptor defined specifically for the given code system.

      Control0..0
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelCode System Version
      282. Act.entryRelationship:careModel.observation.statusCode.displayName
      Definition

      A name or title for the code, under which the sending system shows the code value to its users.

      Control0..0
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplay Name
      284. Act.entryRelationship:careModel.observation.statusCode.sdtcValueSet
      Definition

      The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

      Control0..1
      Typestring(oid: ISO Object Identifier)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
      286. Act.entryRelationship:careModel.observation.statusCode.sdtcValueSetVersion
      Definition

      The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
      288. Act.entryRelationship:careModel.observation.statusCode.originalText
      Definition

      The text or phrase used as the basis for the coding.

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
      LabelOriginal Text
      290. Act.entryRelationship:careModel.observation.statusCode.qualifier
      Definition

      Specifies additional codes that increase the specificity of the the primary code.

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
      LabelQualifier
      292. Act.entryRelationship:careModel.observation.statusCode.translation
      Definition

      A set of other concept descriptors that translate this concept descriptor into other code systems.

      Control0..0
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatThe type of this property is determined using the xsi:typeattribute.
      LabelTranslation
      294. Act.entryRelationship:careModel.observation.effectiveTime
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
      296. Act.entryRelationship:careModel.observation.priorityCode
      ShortSHOULD contain priorityCode
      Comments

      This observation SHOULD contain zero or one [0..1] priorityCode, which SHOULD be selected from ValueSet ActPriority urn:oid:2.16.840.1.113883.1.11.16866 DYNAMIC (CONF:1098-32443).

      Control0..1
      This element is affected by the following invariants: should-priorityCode
      BindingThe codes SHOULD be taken from ActPriority
      (preferred to http://terminology.hl7.org/ValueSet/v3-ActPriority)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      298. Act.entryRelationship:careModel.observation.repeatNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
      300. Act.entryRelationship:careModel.observation.languageCode
      Control0..1
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      302. Act.entryRelationship:careModel.observation.value
      Comments

      This observation SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Care Model urn:oid:2.16.840.1.113883.11.20.9.61 DYNAMIC (CONF:1098-31611).

      Control1..1
      BindingThe codes SHOULD be taken from Care Model .
      (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      XML FormatThe type of this property is determined using the xsi:typeattribute.
      304. Act.entryRelationship:careModel.observation.interpretationCode
      Control0..*
      BindingThe codes SHALL be taken from CDAObservationInterpretation
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      306. Act.entryRelationship:careModel.observation.methodCode
      Control0..*
      BindingFor example codes, see ObservationMethod
      (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
      308. Act.entryRelationship:careModel.observation.targetSiteCode
      Definition

      Drawn from concept domain ActSite

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      310. Act.entryRelationship:careModel.observation.subject
      Definition

      The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

      ShortWho and/or what the observation is about
      Comments

      One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure. This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct)
      Is Modifierfalse
      Requirements

      Observations have no value if you don't know who or what they're about.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      312. Act.entryRelationship:careModel.observation.specimen
      Definition

      The specimen that was used when this observation was made.

      ShortSpecimen used for this observation
      Comments

      Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

      Control0..*1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SpecimenReference(Specimen, Group)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      obs-9: If Observation.specimen is a reference to Group, the group can only have specimens ((reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen))
      314. Act.entryRelationship:careModel.observation.performer
      Definition

      Who was responsible for asserting the observed value as "true".

      ShortWho is responsible for the observation
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
      Is Modifierfalse
      Requirements

      May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      316. Act.entryRelationship:careModel.observation.author
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
      318. Act.entryRelationship:careModel.observation.informant
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
      320. Act.entryRelationship:careModel.observation.participant
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
      322. Act.entryRelationship:careModel.observation.entryRelationship
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      324. Act.entryRelationship:careModel.observation.reference
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
      326. Act.entryRelationship:careModel.observation.precondition
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
      328. Act.entryRelationship:careModel.observation.sdtcPrecondition2
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
      330. Act.entryRelationship:careModel.observation.referenceRange
      Definition

      Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.


      Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

      ShortProvides guide for interpretation
      Comments

      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRootBackboneElement
      Is Modifierfalse
      Requirements

      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
      332. Act.entryRelationship:careModel.observation.referenceRange.nullFlavor
      Definition

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

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

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      336. Act.entryRelationship:careModel.observation.referenceRange.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

      Identifies the type as an HL7 Registered model

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

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

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

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      350. Act.entryRelationship:careModel.observation.referenceRange.typeCode
      Control0..1
      BindingThe codes SHALL be taken from CDAActRelationshipType
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFV
      352. Act.entryRelationship:careModel.observation.referenceRange.observationRange
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
      354. Act.entryRelationship:careModel.observation.sdtcInFulfillmentOf1
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.
      356. Act.entryRelationship:careModel.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      358. Act.entryRelationship:careModel.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      360. Act.entryRelationship:careModel.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      362. Act.entryRelationship:careModel.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      364. Act.entryRelationship:careModel.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      366. Act.entryRelationship:careModel.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      368. Act.entryRelationship:indication
      Slice Nameindication
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:1098-31635) such that it

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      370. Act.entryRelationship:indication.nullFlavor
      Definition

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

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

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      374. Act.entryRelationship:indication.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

      Identifies the type as an HL7 Registered model

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

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

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

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

      SHALL contain exactly one [1..1] @typeCode="RSON" has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31636).

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

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

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

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      394. Act.entryRelationship:indication.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      396. Act.entryRelationship:indication.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      398. Act.entryRelationship:indication.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      400. Act.entryRelationship:indication.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      402. Act.entryRelationship:indication.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      404. Act.entryRelationship:indication.observation
      Comments

      SHALL contain exactly one [1..1] Indication (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.19:2014-06-09) (CONF:1098-32634).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Indication)
      406. Act.entryRelationship:indication.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      408. Act.entryRelationship:indication.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      410. Act.entryRelationship:indication.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      412. Act.entryRelationship:indication.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      414. Act.entryRelationship:indication.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      416. Act.entryRelationship:indication.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      418. Act.reference
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
      420. Act.precondition
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
      422. Act.sdtcPrecondition2
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
      424. Act.sdtcInFulfillmentOf1
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

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

      0. Act
      Logical ContainerClinicalDocument (CDA Class)
      ValidationInstance of this type are validated by templateId
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
      Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
      should-priorityCode: SHOULD contain priorityCode (priorityCode.exists())
      should-author: SHOULD contain author (author.exists())
      2. Act.templateId
      Control1..?
      SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • 4. Act.templateId:referral-act
        Slice Namereferral-act
        Control1..1
        6. Act.templateId:referral-act.root
        Control1..?
        Pattern Value2.16.840.1.113883.10.20.22.4.140
        8. Act.templateId:referral-act.extension
        Control0..0
        10. Act.classCode
        Comments

        SHALL contain exactly one [1..1] @classCode="PCPR" provision of care (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-30884).

        Fixed ValuePCPR
        12. Act.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode, which SHALL be selected from ValueSet Referral Act moodCode urn:oid:2.16.840.1.113883.11.20.9.66 STATIC 2014-09-01 (CONF:1098-30885).

        BindingThe codes SHALL be taken from Patient Referral Act moodCode .
        (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66)
        14. Act.id
        ShortIn the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
        Comments

        SHALL contain at least one [1..*] id (CONF:1098-30888).

        Control1..?
        16. Act.code
        Comments

        SHALL contain exactly one [1..1] code, which SHALL be selected from ValueSet Referral Types urn:oid:2.16.840.1.113883.11.20.9.56 DYNAMIC (CONF:1098-30889).

        BindingThe codes SHALL be taken from Referral Types .
        (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56)
        18. Act.text
        ShortSHOULD reference the portion of section narrative text corresponding to this entry
        20. Act.text.reference
        Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
        22. Act.statusCode
        Comments

        SHALL contain exactly one [1..1] statusCode (CONF:1098-30892).

        Control1..?
        24. Act.statusCode.nullFlavor
        Control0..0
        26. Act.statusCode.code
        Control1..?
        BindingThe codes SHALL be taken from ActStatus
        (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
        28. Act.effectiveTime
        ShortThe effectiveTime represents the time when the future referral is intended to take place.
        Comments

        SHALL contain exactly one [1..1] effectiveTime (CONF:1098-30893).

        Control1..?
        30. Act.priorityCode
        ShortSHOULD contain priorityCode
        Comments

        SHOULD contain zero or one [0..1] priorityCode (CONF:1098-32623).

        32. Act.author
        ShortSHOULD contain author
        Comments

        SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1098-31612).

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

        MAY contain zero or more [0..*] participant (CONF:1098-32635).

        36. Act.participant.typeCode
        Comments

        The participant, if present, SHALL contain exactly one [1..1] @typeCode. Use REFT to represent the referred-to provider.

        38. Act.participant.participantRole
        Comments

        The participant, if present, SHALL contain exactly one [1..1] participantRole (CONF:1098-32636).

        40. Act.participant.participantRole.code
        Comments

        This participantRole MAY contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1098-32637).

        BindingThe codes SHOULD be taken from Healthcare Provider Taxonomy .
        (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066)
        42. Act.entryRelationship
        ShortThe following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
        SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ observation
        • 44. Act.entryRelationship:careModel
          Slice NamecareModel
          ShortThe following entryRelationship represents whether the referral is for full or shared care.
          Comments

          MAY contain zero or more [0..*] entryRelationship (CONF:1098-31604) such that it

          Control0..*
          46. Act.entryRelationship:careModel.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="SUBJ" has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31613).

          Fixed ValueSUBJ
          48. Act.entryRelationship:careModel.observation
          Comments

          SHALL contain exactly one [1..1] observation (CONF:1098-31605).

          Control1..?
          Invariantsshould-priorityCode: SHOULD contain priorityCode (priorityCode.exists())
          50. Act.entryRelationship:careModel.observation.classCode
          Comments

          This observation SHALL contain exactly one [1..1] @classCode="OBS" observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31606).

          Fixed ValueOBS
          52. Act.entryRelationship:careModel.observation.moodCode
          Comments

          This observation SHALL contain exactly one [1..1] @moodCode="RQO" request (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31607).

          Fixed ValueRQO
          54. Act.entryRelationship:careModel.observation.code
          Comments

          This observation SHALL contain exactly one [1..1] code (CONF:1098-31608).

          56. Act.entryRelationship:careModel.observation.code.code
          Comments

          This code SHALL contain exactly one [1..1] @code="ASSERTION" assertion (CONF:1098-31619).

          Control1..?
          Pattern ValueASSERTION
          58. Act.entryRelationship:careModel.observation.code.codeSystem
          Comments

          This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.4 " (CodeSystem: HL7ActCode urn:oid:2.16.840.1.113883.5.4) (CONF:1098-31620).

          Control1..?
          Pattern Value2.16.840.1.113883.5.4
          60. Act.entryRelationship:careModel.observation.statusCode
          Comments

          This observation SHALL contain exactly one [1..1] statusCode (CONF:1098-31614).

          Control1..?
          62. Act.entryRelationship:careModel.observation.statusCode.code
          Comments

          This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:1098-31615).

          Control1..?
          Fixed Valuecompleted
          64. Act.entryRelationship:careModel.observation.priorityCode
          ShortSHOULD contain priorityCode
          Comments

          This observation SHOULD contain zero or one [0..1] priorityCode, which SHOULD be selected from ValueSet ActPriority urn:oid:2.16.840.1.113883.1.11.16866 DYNAMIC (CONF:1098-32443).

          BindingThe codes SHOULD be taken from ActPriority
          (preferred to http://terminology.hl7.org/ValueSet/v3-ActPriority)
          66. Act.entryRelationship:careModel.observation.value
          Comments

          This observation SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Care Model urn:oid:2.16.840.1.113883.11.20.9.61 DYNAMIC (CONF:1098-31611).

          Control1..1
          BindingThe codes SHOULD be taken from Care Model .
          (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          68. Act.entryRelationship:indication
          Slice Nameindication
          Comments

          MAY contain zero or more [0..*] entryRelationship (CONF:1098-31635) such that it

          Control0..*
          70. Act.entryRelationship:indication.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="RSON" has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31636).

          Fixed ValueRSON
          72. Act.entryRelationship:indication.observation
          Comments

          SHALL contain exactly one [1..1] Indication (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.19:2014-06-09) (CONF:1098-32634).

          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Indication)

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

          0. Act
          Definition

          Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

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

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

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

          When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

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

          When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

          A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

          Identifies the type as an HL7 Registered model

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

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

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

          When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

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

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

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

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

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelRoot
            Pattern Value2.16.840.1.113883.10.20.22.4.140
            30. Act.templateId:referral-act.extension
            Definition

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

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExtension
            32. Act.classCode
            Comments

            SHALL contain exactly one [1..1] @classCode="PCPR" provision of care (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-30884).

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

            SHALL contain exactly one [1..1] @moodCode, which SHALL be selected from ValueSet Referral Act moodCode urn:oid:2.16.840.1.113883.11.20.9.66 STATIC 2014-09-01 (CONF:1098-30885).

            Control1..1
            BindingThe codes SHALL be taken from Patient Referral Act moodCode .
            (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            36. Act.negationInd
            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            38. Act.id
            ShortIn the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
            Comments

            SHALL contain at least one [1..*] id (CONF:1098-30888).

            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            40. Act.code
            Comments

            SHALL contain exactly one [1..1] code, which SHALL be selected from ValueSet Referral Types urn:oid:2.16.840.1.113883.11.20.9.56 DYNAMIC (CONF:1098-30889).

            Control1..1
            BindingThe codes SHALL be taken from Referral Types .
            (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            42. Act.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Control0..1
            This element is affected by the following invariants: should-text-ref-value
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            44. Act.text.nullFlavor
            Definition

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

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

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

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

            The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

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

            Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

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

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

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

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

            Control0..1
            BindingFor example codes, see MediaType
            (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelMedia Type
            56. Act.text.representation
            Control0..1
            BindingThe codes SHALL be taken from CDABinaryDataEncoding
            (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            58. Act.text.xmlText
            Definition

            Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

            ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
            Comments

            This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

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

            A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
            LabelReference
            Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
            62. Act.text.thumbnail
            Definition

            An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelThumbnail
            InvariantsED-1: Thumbnails cannot contain their own thumbnails (thumbnail.empty())
            64. Act.statusCode
            Comments

            SHALL contain exactly one [1..1] statusCode (CONF:1098-30892).

            Control1..1
            BindingThe codes SHALL be taken from ActStatus
            (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            66. Act.statusCode.nullFlavor
            Definition

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

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

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            Control1..1
            BindingThe codes SHALL be taken from ActStatus
            (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            70. Act.statusCode.codeSystem
            Definition

            Specifies the code system that defines the code.

            Control0..0
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            72. Act.statusCode.codeSystemName
            Definition

            The common name of the coding system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            74. Act.statusCode.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            76. Act.statusCode.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            78. Act.statusCode.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            80. Act.statusCode.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            82. Act.statusCode.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            84. Act.statusCode.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            86. Act.statusCode.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            LabelTranslation
            88. Act.effectiveTime
            ShortThe effectiveTime represents the time when the future referral is intended to take place.
            Comments

            SHALL contain exactly one [1..1] effectiveTime (CONF:1098-30893).

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
            90. Act.priorityCode
            Shorticon Added:SHOULD contain priorityCode
            Comments

            SHOULD contain zero or one [0..1] priorityCode (CONF:1098-32623).

            Control0..1
            This element is affected by the following invariants: should-priorityCode
            BindingFor example codes, see ActPriority
            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            92. Act.languageCode
            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            94. Act.subject
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
            96. Act.specimen
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
            98. Act.performer
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
            100. Act.author
            Shorticon Added:SHOULD contain author
            Comments

            SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1098-31612).

            Control0..*
            This element is affected by the following invariants: should-author
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
            102. Act.informant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
            104. Act.participant
            Comments

            MAY contain zero or more [0..*] participant (CONF:1098-32635).

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
            106. Act.participant.nullFlavor
            Definition

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

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

            When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            110. Act.participant.typeId
            Definition

            When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

            Identifies the type as an HL7 Registered model

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

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

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

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

            The participant, if present, SHALL contain exactly one [1..1] @typeCode. Use REFT to represent the referred-to provider.

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

            The participant, if present, SHALL contain exactly one [1..1] participantRole (CONF:1098-32636).

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
            136. Act.participant.participantRole.nullFlavor
            Definition

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

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

            When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            140. Act.participant.participantRole.typeId
            Definition

            When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

            Identifies the type as an HL7 Registered model

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

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

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

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            154. Act.participant.participantRole.classCode
            Control0..1
            BindingThe codes SHALL be taken from CDARoleClassRoot
            (required to http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Default ValueROL
            156. Act.participant.participantRole.id
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            158. Act.participant.participantRole.sdtcIdentifiedBy
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
            XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameidentifiedBy.
            160. Act.participant.participantRole.code
            Comments

            This participantRole MAY contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1098-32637).

            Control0..1
            BindingThe codes SHOULD be taken from Healthcare Provider Taxonomy .
            (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            162. Act.participant.participantRole.sdtcSpecialty
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namespecialty.
            164. Act.participant.participantRole.addr
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD
            166. Act.participant.participantRole.telecom
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
            168. Act.participant.participantRole.playingDevice
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Device
            170. Act.participant.participantRole.playingEntity
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
            172. Act.participant.participantRole.scopingEntity
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Entity
            174. Act.entryRelationship
            ShortThe following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
            SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ observation
            • 176. Act.entryRelationship:careModel
              Slice NamecareModel
              ShortThe following entryRelationship represents whether the referral is for full or shared care.
              Comments

              MAY contain zero or more [0..*] entryRelationship (CONF:1098-31604) such that it

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              178. Act.entryRelationship:careModel.nullFlavor
              Definition

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

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

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              182. Act.entryRelationship:careModel.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

              Identifies the type as an HL7 Registered model

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

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

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

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

              SHALL contain exactly one [1..1] @typeCode="SUBJ" has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31613).

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

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

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

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              202. Act.entryRelationship:careModel.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              204. Act.entryRelationship:careModel.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              206. Act.entryRelationship:careModel.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              208. Act.entryRelationship:careModel.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              210. Act.entryRelationship:careModel.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              212. Act.entryRelationship:careModel.observation
              Comments

              SHALL contain exactly one [1..1] observation (CONF:1098-31605).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              Invariantsshould-priorityCode: SHOULD contain priorityCode (priorityCode.exists())
              214. Act.entryRelationship:careModel.observation.nullFlavor
              Definition

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

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

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              218. Act.entryRelationship:careModel.observation.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

              Identifies the type as an HL7 Registered model

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

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

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

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              232. Act.entryRelationship:careModel.observation.classCode
              Comments

              This observation SHALL contain exactly one [1..1] @classCode="OBS" observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31606).

              Control1..1
              BindingThe codes SHALL be taken from CDAActClassObservation
              (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueOBS
              234. Act.entryRelationship:careModel.observation.moodCode
              Comments

              This observation SHALL contain exactly one [1..1] @moodCode="RQO" request (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31607).

              Control1..1
              BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
              (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueRQO
              236. Act.entryRelationship:careModel.observation.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              238. Act.entryRelationship:careModel.observation.id
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              240. Act.entryRelationship:careModel.observation.sdtcCategory
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
              242. Act.entryRelationship:careModel.observation.code
              Comments

              This observation SHALL contain exactly one [1..1] code (CONF:1098-31608).

              Control1..1
              BindingFor example codes, see ObservationType
              (example to http://terminology.hl7.org/ValueSet/v3-ObservationType)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              244. Act.entryRelationship:careModel.observation.code.nullFlavor
              Definition

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

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

              The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

              Comments

              This code SHALL contain exactly one [1..1] @code="ASSERTION" assertion (CONF:1098-31619).

              Control1..1
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode
              Pattern ValueASSERTION
              248. Act.entryRelationship:careModel.observation.code.codeSystem
              Definition

              Specifies the code system that defines the code.

              Comments

              This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.4 " (CodeSystem: HL7ActCode urn:oid:2.16.840.1.113883.5.4) (CONF:1098-31620).

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System
              Pattern Value2.16.840.1.113883.5.4
              250. Act.entryRelationship:careModel.observation.code.codeSystemName
              Definition

              The common name of the coding system.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System Name
              252. Act.entryRelationship:careModel.observation.code.codeSystemVersion
              Definition

              If applicable, a version descriptor defined specifically for the given code system.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System Version
              254. Act.entryRelationship:careModel.observation.code.displayName
              Definition

              A name or title for the code, under which the sending system shows the code value to its users.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplay Name
              256. Act.entryRelationship:careModel.observation.code.sdtcValueSet
              Definition

              The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

              Control0..1
              Typestring(oid: ISO Object Identifier)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
              258. Act.entryRelationship:careModel.observation.code.sdtcValueSetVersion
              Definition

              The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
              260. Act.entryRelationship:careModel.observation.code.originalText
              Definition

              The text or phrase used as the basis for the coding.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
              LabelOriginal Text
              262. Act.entryRelationship:careModel.observation.code.qualifier
              Definition

              Specifies additional codes that increase the specificity of the the primary code.

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
              LabelQualifier
              264. Act.entryRelationship:careModel.observation.code.translation
              Definition

              A set of other concept descriptors that translate this concept descriptor into other code systems.

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              LabelTranslation
              266. Act.entryRelationship:careModel.observation.derivationExpr
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
              268. Act.entryRelationship:careModel.observation.text
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              270. Act.entryRelationship:careModel.observation.statusCode
              Comments

              This observation SHALL contain exactly one [1..1] statusCode (CONF:1098-31614).

              Control1..1
              BindingThe codes SHALL be taken from ActStatus
              (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              272. Act.entryRelationship:careModel.observation.statusCode.nullFlavor
              Definition

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

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

              The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

              Comments

              This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:1098-31615).

              Control1..1
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode
              Fixed Valuecompleted
              276. Act.entryRelationship:careModel.observation.statusCode.codeSystem
              Definition

              Specifies the code system that defines the code.

              Control0..0
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System
              278. Act.entryRelationship:careModel.observation.statusCode.codeSystemName
              Definition

              The common name of the coding system.

              Control0..0
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System Name
              280. Act.entryRelationship:careModel.observation.statusCode.codeSystemVersion
              Definition

              If applicable, a version descriptor defined specifically for the given code system.

              Control0..0
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelCode System Version
              282. Act.entryRelationship:careModel.observation.statusCode.displayName
              Definition

              A name or title for the code, under which the sending system shows the code value to its users.

              Control0..0
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplay Name
              284. Act.entryRelationship:careModel.observation.statusCode.sdtcValueSet
              Definition

              The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

              Control0..1
              Typestring(oid: ISO Object Identifier)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
              286. Act.entryRelationship:careModel.observation.statusCode.sdtcValueSetVersion
              Definition

              The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
              288. Act.entryRelationship:careModel.observation.statusCode.originalText
              Definition

              The text or phrase used as the basis for the coding.

              Control0..0
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
              LabelOriginal Text
              290. Act.entryRelationship:careModel.observation.statusCode.qualifier
              Definition

              Specifies additional codes that increase the specificity of the the primary code.

              Control0..0
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
              LabelQualifier
              292. Act.entryRelationship:careModel.observation.statusCode.translation
              Definition

              A set of other concept descriptors that translate this concept descriptor into other code systems.

              Control0..0
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              LabelTranslation
              294. Act.entryRelationship:careModel.observation.effectiveTime
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
              296. Act.entryRelationship:careModel.observation.priorityCode
              ShortSHOULD contain priorityCode
              Comments

              This observation SHOULD contain zero or one [0..1] priorityCode, which SHOULD be selected from ValueSet ActPriority urn:oid:2.16.840.1.113883.1.11.16866 DYNAMIC (CONF:1098-32443).

              Control0..1
              This element is affected by the following invariants: should-priorityCode
              BindingThe codes SHOULD be taken from ActPriority
              (preferred to http://terminology.hl7.org/ValueSet/v3-ActPriority)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
              298. Act.entryRelationship:careModel.observation.repeatNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
              300. Act.entryRelationship:careModel.observation.languageCode
              Control0..1
              BindingThe codes SHALL be taken from AllLanguages
              (required to http://hl7.org/fhir/ValueSet/all-languages)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              302. Act.entryRelationship:careModel.observation.value
              Comments

              This observation SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Care Model urn:oid:2.16.840.1.113883.11.20.9.61 DYNAMIC (CONF:1098-31611).

              Control1..1
              BindingThe codes SHOULD be taken from Care Model .
              (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              304. Act.entryRelationship:careModel.observation.interpretationCode
              Control0..*
              BindingThe codes SHALL be taken from CDAObservationInterpretation
              (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
              306. Act.entryRelationship:careModel.observation.methodCode
              Control0..*
              BindingFor example codes, see ObservationMethod
              (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
              308. Act.entryRelationship:careModel.observation.targetSiteCode
              Definition

              Drawn from concept domain ActSite

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              310. Act.entryRelationship:careModel.observation.subject
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
              312. Act.entryRelationship:careModel.observation.specimen
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
              314. Act.entryRelationship:careModel.observation.performer
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
              316. Act.entryRelationship:careModel.observation.author
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
              318. Act.entryRelationship:careModel.observation.informant
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
              320. Act.entryRelationship:careModel.observation.participant
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
              322. Act.entryRelationship:careModel.observation.entryRelationship
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              324. Act.entryRelationship:careModel.observation.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              326. Act.entryRelationship:careModel.observation.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              328. Act.entryRelationship:careModel.observation.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              330. Act.entryRelationship:careModel.observation.referenceRange
              Definition

              Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
              332. Act.entryRelationship:careModel.observation.referenceRange.nullFlavor
              Definition

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

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

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              336. Act.entryRelationship:careModel.observation.referenceRange.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

              Identifies the type as an HL7 Registered model

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

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

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

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              350. Act.entryRelationship:careModel.observation.referenceRange.typeCode
              Control0..1
              BindingThe codes SHALL be taken from CDAActRelationshipType
              (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFV
              352. Act.entryRelationship:careModel.observation.referenceRange.observationRange
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
              354. Act.entryRelationship:careModel.observation.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.
              356. Act.entryRelationship:careModel.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              358. Act.entryRelationship:careModel.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              360. Act.entryRelationship:careModel.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              362. Act.entryRelationship:careModel.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              364. Act.entryRelationship:careModel.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              366. Act.entryRelationship:careModel.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              368. Act.entryRelationship:indication
              Slice Nameindication
              Comments

              MAY contain zero or more [0..*] entryRelationship (CONF:1098-31635) such that it

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              370. Act.entryRelationship:indication.nullFlavor
              Definition

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

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

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              374. Act.entryRelationship:indication.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

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

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

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

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

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

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

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

              Identifies the type as an HL7 Registered model

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

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

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

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

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

              SHALL contain exactly one [1..1] @typeCode="RSON" has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31636).

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

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

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

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              394. Act.entryRelationship:indication.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              396. Act.entryRelationship:indication.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              398. Act.entryRelationship:indication.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              400. Act.entryRelationship:indication.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              402. Act.entryRelationship:indication.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              404. Act.entryRelationship:indication.observation
              Comments

              SHALL contain exactly one [1..1] Indication (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.19:2014-06-09) (CONF:1098-32634).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Indication)
              406. Act.entryRelationship:indication.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              408. Act.entryRelationship:indication.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              410. Act.entryRelationship:indication.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              412. Act.entryRelationship:indication.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              414. Act.entryRelationship:indication.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              416. Act.entryRelationship:indication.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              418. Act.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              420. Act.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              422. Act.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              424. Act.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.