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 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

Logical Model: SmokingStatus - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the SmokingStatus logical model.

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

0. Observation
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())
coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded ((code.code = '72166-2' or code.code = '11367-0') implies value.code.exists())
2. Observation.templateId
Control1..?
SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Observation.templateId:tobacco-use
    Slice Nametobacco-use
    Control1..1
    6. Observation.templateId:tobacco-use.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.511
    8. Observation.templateId:tobacco-use.extension
    Control1..?
    Pattern Value2024-05-01
    10. Observation.classCode
    Fixed ValueOBS
    12. Observation.moodCode
    Fixed ValueEVN
    14. Observation.id
    Control1..?
    16. Observation.code
    BindingThe codes SHALL be taken from Smoking Status Type .
    (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6)

    Smoking status type

    18. Observation.code.code
    Control1..?
    20. Observation.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    22. Observation.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('#'))
    24. Observation.statusCode
    Control1..?
    26. Observation.statusCode.code
    Control1..?
    Fixed Valuecompleted
    28. Observation.effectiveTime
    Control1..?
    30. Observation.effectiveTime.value
    ShortRepresents a timestamp indicating a "point in time" when the observation was true
    32. Observation.effectiveTime.low
    ShortRepresents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
    34. Observation.effectiveTime.high
    ShortRepresents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
    36. Observation.value
    ShortREAL shall only be used for Smoking Status where code = 401201003 or 782516008
    Control1..1
    TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/SC
    SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 38. Observation.value:packYears
      Slice NamepackYears
      ShortOnly used for Smoking Status where code = 401201003 or 782516008
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/REAL
      40. Observation.value:coded
      Slice Namecoded
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      42. Observation.value:coded.code
      Control1..?
      BindingThe codes SHALL be taken from Smoking status comprehensive .
      (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3)

      Smoking status comprehensive

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

      0. Observation
      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())
      coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded ((code.code = '72166-2' or code.code = '11367-0') implies value.code.exists())
      2. 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
      4. 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
      6. 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())
      8. 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
      10. 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
      12. 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
      14. 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
      16. 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
      18. 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

      Control1..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 20. Observation.templateId:tobacco-use
        Slice Nametobacco-use
        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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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 Value2.16.840.1.113883.10.20.22.4.511
        30. Observation.templateId:tobacco-use.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
        Pattern Value2024-05-01
        32. Observation.classCode
        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
        34. Observation.moodCode
        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 ValueEVN
        36. 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.
        38. 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.

        Control10..*1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
        Is Modifierfalse
        40. 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.
        42. Observation.code
        Definition

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

        ShortType of observation (code / type)
        Comments

        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
        BindingThe codes SHALL be taken from For example codes, see Smoking Status Type .http://hl7.org/fhir/ValueSet/observation-codes
        (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6)

        Smoking status type


        Codes identifying names of simple observations.

        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()))
        44. 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
        46. 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.

        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
        48. Observation.code.codeSystem
        Definition

        Specifies the code system that defines the code.

        Control0..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
        50. 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
        52. 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
        54. 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
        56. 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.
        58. 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.
        60. 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
        62. 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
        64. 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
        66. Observation.derivationExpr
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
        68. 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.

        ShortSHOULD reference the portion of section narrative text corresponding to this entryText 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()))
        70. Observation.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
        72. Observation.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
        74. Observation.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
        76. Observation.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
        78. Observation.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
        80. Observation.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
        82. Observation.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.
        84. Observation.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.
        86. Observation.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('#'))
        88. Observation.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
        90. Observation.statusCode
        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
        92. 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
        94. 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.

        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
        96. 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
        98. 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
        100. 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
        102. 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
        104. 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.
        106. 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.
        108. 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
        110. 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
        112. 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
        114. Observation.effectiveTime
        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
        116. Observation.effectiveTime.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
        118. Observation.effectiveTime.value
        Definition

        A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

        ShortRepresents a timestamp indicating a "point in time" when the observation was true
        Control0..1
        TypedateTime(ts: Point in Time)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
        XML FormatIn the XML format, this property is represented as an attribute.
        120. Observation.effectiveTime.operator
        Definition

        A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.

        Control0..1
        BindingThe codes SHALL be taken from CDASetOperator
        (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
        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 ValueI
        122. Observation.effectiveTime.low
        Definition

        This is the low limit of the interval.

        ShortRepresents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
        LabelLow Boundary
        124. Observation.effectiveTime.center
        Definition

        The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
        LabelCentral Value
        126. Observation.effectiveTime.width
        Definition

        The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
        LabelWidth
        128. Observation.effectiveTime.high
        Definition

        This is the high limit of the interval.

        ShortRepresents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
        LabelHigh Boundary
        130. Observation.priorityCode
        Control0..1
        BindingFor example codes, see ActPriority
        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        132. Observation.repeatNumber
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
        134. 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
        136. Observation.value
        ShortREAL shall only be used for Smoking Status where code = 401201003 or 782516008
        Control1..1
        TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/REAL
        XML FormatThe type of this property is determined using the xsi:typeattribute.
        SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 138. Observation.value:packYears
          Slice NamepackYears
          ShortOnly used for Smoking Status where code = 401201003 or 782516008
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/REAL
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          140. Observation.value:coded
          Slice Namecoded
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          142. Observation.value:coded.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. Observation.value:coded.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 Smoking status comprehensive .
          (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3)

          Smoking status comprehensive

          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
          146. Observation.value:coded.codeSystem
          Definition

          Specifies the code system that defines the code.

          Control0..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
          148. Observation.value:coded.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
          150. Observation.value:coded.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
          152. Observation.value:coded.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
          154. Observation.value:coded.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.
          156. Observation.value:coded.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.
          158. Observation.value:coded.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
          160. Observation.value:coded.qualifier
          Definition

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

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
          LabelQualifier
          162. Observation.value:coded.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
          164. 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
          166. 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
          168. Observation.targetSiteCode
          Definition

          Drawn from concept domain ActSite

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          170. 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()))
          172. 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))
          174. 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()))
          176. Observation.author
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
          178. Observation.informant
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
          180. Observation.participant
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
          182. Observation.entryRelationship
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
          184. Observation.reference
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
          186. Observation.precondition
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
          188. 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.
          190. 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())
          192. 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
          194. 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
          196. 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())
          198. 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
          200. 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
          202. 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
          204. 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
          206. 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
          208. 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
          210. 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
          212. Observation.referenceRange.observationRange
          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
          214. 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.

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

          0. Observation
          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())
          coded-value: When code is Smoking Status (72166-2) or Tobacco Use (11367-0), the value SHALL be coded ((code.code = '72166-2' or code.code = '11367-0') implies value.code.exists())
          2. 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
          4. 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
          6. 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())
          8. 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
          10. 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
          12. 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
          14. 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
          16. 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
          18. 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

          Control1..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ root
          • value @ extension
          • 20. Observation.templateId:tobacco-use
            Slice Nametobacco-use
            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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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. Observation.templateId:tobacco-use.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 Value2.16.840.1.113883.10.20.22.4.511
            30. Observation.templateId:tobacco-use.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
            Pattern Value2024-05-01
            32. Observation.classCode
            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
            34. Observation.moodCode
            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 ValueEVN
            36. 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.
            38. Observation.id
            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            40. 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.
            42. Observation.code
            Control1..1
            BindingThe codes SHALL be taken from Smoking Status Type .
            (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6)

            Smoking status type

            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            44. 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
            46. 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.

            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
            48. Observation.code.codeSystem
            Definition

            Specifies the code system that defines the code.

            Control0..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
            50. 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
            52. 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
            54. 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
            56. 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.
            58. 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.
            60. 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
            62. 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
            64. 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
            66. Observation.derivationExpr
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
            68. Observation.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            70. Observation.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
            72. Observation.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
            74. Observation.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
            76. Observation.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
            78. Observation.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
            80. Observation.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
            82. Observation.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.
            84. Observation.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.
            86. Observation.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('#'))
            88. Observation.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
            90. Observation.statusCode
            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
            92. 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
            94. 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.

            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
            96. 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
            98. 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
            100. 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
            102. 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
            104. 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.
            106. 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.
            108. 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
            110. 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
            112. 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
            114. Observation.effectiveTime
            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
            116. Observation.effectiveTime.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
            118. Observation.effectiveTime.value
            Definition

            A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

            ShortRepresents a timestamp indicating a "point in time" when the observation was true
            Control0..1
            TypedateTime(ts: Point in Time)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
            XML FormatIn the XML format, this property is represented as an attribute.
            120. Observation.effectiveTime.operator
            Definition

            A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.

            Control0..1
            BindingThe codes SHALL be taken from CDASetOperator
            (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
            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 ValueI
            122. Observation.effectiveTime.low
            Definition

            This is the low limit of the interval.

            ShortRepresents the earliest time the observation was true. Should not be used for temporal codes (e.g. 266919005 - Never smoked tobacco)
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
            LabelLow Boundary
            124. Observation.effectiveTime.center
            Definition

            The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
            LabelCentral Value
            126. Observation.effectiveTime.width
            Definition

            The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
            LabelWidth
            128. Observation.effectiveTime.high
            Definition

            This is the high limit of the interval.

            ShortRepresents the last known time the observation was true. If the observation is still true, set `@nullFlavor` to `UNK`.
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
            LabelHigh Boundary
            130. Observation.priorityCode
            Control0..1
            BindingFor example codes, see ActPriority
            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            132. Observation.repeatNumber
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
            134. 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
            136. Observation.value
            ShortREAL shall only be used for Smoking Status where code = 401201003 or 782516008
            Control1..1
            TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/REAL
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 138. Observation.value:packYears
              Slice NamepackYears
              ShortOnly used for Smoking Status where code = 401201003 or 782516008
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/REAL
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              140. Observation.value:coded
              Slice Namecoded
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              XML FormatThe type of this property is determined using the xsi:typeattribute.
              142. Observation.value:coded.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. Observation.value:coded.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 Smoking status comprehensive .
              (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.3)

              Smoking status comprehensive

              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
              146. Observation.value:coded.codeSystem
              Definition

              Specifies the code system that defines the code.

              Control0..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
              148. Observation.value:coded.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
              150. Observation.value:coded.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
              152. Observation.value:coded.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
              154. Observation.value:coded.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.
              156. Observation.value:coded.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.
              158. Observation.value:coded.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
              160. Observation.value:coded.qualifier
              Definition

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

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
              LabelQualifier
              162. Observation.value:coded.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
              164. 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
              166. 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
              168. Observation.targetSiteCode
              Definition

              Drawn from concept domain ActSite

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
              170. Observation.subject
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
              172. Observation.specimen
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
              174. Observation.performer
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
              176. Observation.author
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
              178. Observation.informant
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
              180. Observation.participant
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
              182. Observation.entryRelationship
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              184. Observation.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              186. Observation.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              188. 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.
              190. 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
              192. 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
              194. 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
              196. 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())
              198. 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
              200. 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
              202. 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
              204. 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
              206. 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
              208. 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
              210. 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
              212. Observation.referenceRange.observationRange
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
              214. 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.