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

Downloads

Full Implementation Guide

The entire implementation guide (including the HTML files, definitions, validation information, etc.) may be downloaded here.

In addition, there are format specific definitions files.

• XML
• JSON
• TTL

Examples: All the examples that are used in this Implementation Guide are available for download:

• XML
• JSON
• TTl

Cross Version Analysis

Dependency Table

Package hl7.fhir.uv.extensions.r5#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.xver-r5.r4#0.1.0 Extensions for Using Data Elements from FHIR R5 in FHIR R4 (built Fri, Mar 20, 2026 15:40+1100+11:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

Package hl7.fhir.uv.extensions.r4#5.3.0-ballot-tc1 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Aug 3, 2025 06:28+1000+10:00)

Package hl7.fhir.uv.sdc#4.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. (built Tue, Mar 24, 2026 16:16+1100+11:00)

Package hl7.fhir.us.core#current The US Core Implementation Guide defines the minimum set of FHIR RESTful interactions for each of the US Core Profiles to access patient data. The Data Access Framework and the Argonaut DSTU2 guides initially formed the basis for US Core. The Profiles are updated annually to support the latest requirements from The Office of the National Coordinator for Health Information Technology (ONC) U.S. Core Data for Interoperability (USCDI). For a summary of significant changes and a detailed list of the changes between versions, see the Change Notes at https://hl7.org/fhir/us/core/changes.html (built Tue, Apr 14, 2026 22:44+0000+00:00)

Package hl7.fhir.uv.tools.r5#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

Global Profiles Table

There are no Global profiles defined

IP Statements

This publication includes IP covered under the following statements.

• © Copyright 2022 American Medical Association
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  • NUCC Provider Taxonomy: AdvanceDirectiveObservation, AuthorParticipation... Show 8 more, CarePlan, EncounterActivity, HandoffCommunicationParticipants, OperativeNote, ProcedureNote, ReferralAct, TransferSummary and USRealmHeader
• ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: ActivitiesSection, AdmissionDiagnosisSection... Show 228 more, AdmissionMedication, AdmissionMedicationsSectionEntriesOptional, AdvanceDirectiveExistenceObservation, AdvanceDirectiveObservation, AdvanceDirectiveOrganizer, AdvanceDirectivesSection, AgeObservation, AgeRangeObservation, AllergiesAndIntolerancesSection, AllergyConcernAct, AllergyIntoleranceObservation, AllergyStatusObservation, AnesthesiaSection, AssessmentScaleObservation, AssessmentScaleSupportingObservation, AssessmentSection, AssessmentandPlanSection, AuthorParticipation, AuthorizationActivity, AverageBloodPressureOrganizer, BasicIndustryObservation, BasicOccupationObservation, BirthSexObservation, BrandNameObservation, CCDA, CareExperiencePreference, CarePlan, CarePlanAct, CareTeamMemberAct, CareTeamMemberScheduleObservation, CareTeamOrganizer, CareTeamTypeObservation, CareTeamsSection, CaregiverCharacteristics, CatalogNumberObservation, CharacteristicsofHomeEnvironment, ChiefComplaintSection, ChiefComplaintandReasonforVisitSection, CommentActivity, CompanyNameObservation, ComplicationsSection, ConsultationNote, ContinuityofCareDocumentCCD, CourseofCareSection, CoverageActivity, CriticalityObservation, CulturalandReligiousObservation, DateOfDiagnosisAct, DeceasedObservation, DeviceIdentifierObservation, DisabilityStatusObservation, DischargeDiagnosisSection, DischargeMedication, DischargeMedicationsSection, DischargeSummary, DistinctIdentificationCodeObservation, DrugMonitoringAct, DrugVehicle, EncounterActivity, EncounterDiagnosis, EncountersSection, EntryReference, EstimatedDateofDelivery, ExpirationDateObservation, ExternalDocumentReference, FamilyHistoryDeathObservation, FamilyHistoryObservation, FamilyHistoryOrganizer, FamilyHistorySection, FunctionalStatusObservation, FunctionalStatusOrganizer, FunctionalStatusSection, GenderIdentityObservation, GeneralStatusSection, GoalObservation, GoalsSection, HandoffCommunicationParticipants, HealthConcernAct, HealthConcernsSection, HealthStatusObservation, HighestPressureUlcerStage, HistoryandPhysical, HistoryofPresentIllnessSection, HospitalAdmissionDiagnosis, HospitalConsultationsSection, HospitalCourseSection, HospitalDischargeDiagnosis, HospitalDischargeInstructionsSection, HospitalDischargePhysicalSection, HospitalDischargeStudiesSummarySection, ImmunizationActivity, ImmunizationMedicationInformation, ImmunizationNotGivenReason, ImmunizationsSection, ImplantableDeviceStatusObservation, Indication, IndividualPronounObservation, InstructionActivity, InstructionObservation, InstructionsSection, InterpreterNeededObservation, InterventionAct, LatexSafetyObservation, LongitudinalCareWoundObservation, LotOrBatchNumberObservation, MRISafetyObservation, ManufacturingDateObservation, MedicalEquipmentOrganizer, MedicalEquipmentSection, MedicalGeneralHistorySection, MedicationActivity, MedicationAdherence, MedicationDispense, MedicationFreeTextSig, MedicationInformation, MedicationSupplyOrder, MedicationsAdministeredSection, MedicationsSection, MentalStatusObservation, MentalStatusOrganizer, MentalStatusSection, ModelNumberObservation, NonMedicinalSupplyActivity, NoteActivity, NotesSection, NumberofPressureUlcersObservation, NutritionAssessment, NutritionRecommendation, NutritionSection, NutritionalStatusObservation, ObjectiveSection, OperativeNote, OperativeNoteFluidsSection, OperativeNoteSurgicalProcedureSection, OutcomeObservation, OutcomesSection, PastMedicalHistory, PayersSection, PhysicalExamSection, PlannedCoverage, PlannedEncounter, PlannedImmunizationActivity, PlannedInterventionAct, PlannedMedicationActivity, PlannedProcedure, PlannedProcedureSection, PlannedSupply, PlanofTreatmentSection, PolicyActivity, PostoperativeDiagnosisSection, PostprocedureDiagnosis, PostprocedureDiagnosisSection, PreconditionforSubstanceAdministration, PregnancyIntentionInNextYear, PregnancySection, PregnancyStatusObservation, PreoperativeDiagnosis, PreoperativeDiagnosisSection, PriorityPreference, ProblemConcernAct, ProblemObservation, ProblemSection, ProblemStatus, ProcedureActivityProcedure, ProcedureDescriptionSection, ProcedureDispositionSection, ProcedureEstimatedBloodLossSection, ProcedureFindingsSection, ProcedureImplantsSection, ProcedureIndicationsSection, ProcedureNote, ProcedureSpecimensTakenSection, ProceduresSection, ProductInstance, PrognosisObservation, ProgressNote, ProgressTowardGoalObservation, ProvenanceAssemblerParticipation, ProvenanceAuthorParticipation, ReactionObservation, Reason, ReasonforReferralSection, ReasonforVisitSection, ReferralAct, ReferralNote, RelatedPersonRelationshipAndNameParticipant, ResultObservation, ResultOrganizer, ResultsSection, ReviewofSystemsSection, RiskConcernAct, SectionTimeRangeObservation, SelfCareActivitiesADLandIADL, SensoryStatus, SerialNumberObservation, ServiceDeliveryLocation, SeverityObservation, SexObservation, SexParameterForClinicalUseObservation, SexualOrientationObservation, SmokingStatus, SmokingStatusMeaningfulUse, SocialHistoryObservation, SocialHistorySection, SpecimenCollectionProcedure, SpecimenConditionObservation, SubjectiveSection, SubstanceAdministeredAct, SubstanceOrDeviceAllergyIntoleranceObservation, SurgicalDrainsSection, TobaccoUse, TransferSummary, TreatmentInterventionPreference, TribalAffiliationObservation, UDIOrganizer, USRealmAddress, USRealmDateTime, USRealmDateTimeInterval, USRealmHeader, USRealmHeaderforPatientGeneratedDocument, USRealmPatientNamePTNUSFIELDED, USRealmPersonNamePNUSFIELDED, UnstructuredDocument, VitalSignObservation, VitalSignsOrganizer, VitalSignsSection, WoundCharacteristic and WoundMeasurementObservation
• Licensing information can be found here These codes are listed within the UB-04 Data Specifications Manual. The Official UB-04 Data Specifications Manual, copyrighted by the American Hospital Association, is the only official source of UB-04 billing information adopted by the National Uniform Billing Committee. No other publication—governmental or private/commercial—can be considered authoritative. The AHA wants to make you aware that the use of codes, descriptions, or any other content contained in the manual to be used in a software application, publication, or any other derivative work must be properly licensed by the AHA. If your organization uses or intends to use any of the codes or other related content from the manual in this manner, please contact the AHA’s licensing manager, Tim Carlson, at 312.893.6816 or tcarlson@aha.org
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  • AHA NUBC Patient Discharge Status Codes: DischargeSummary and EncounterActivity
• Most of the information on the CDC and ATSDR websites is not subject to copyright, is in the public domain, and may be freely used or reproduced without obtaining copyright permission. For information and exceptions regarding use of CDC material please see https://www.cdc.gov/other/agencymaterials.html
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  • Vaccine Administered Code Set (CVX): ImmunizationMedicationInformation
• Most of the information on the CDC and ATSDR websites is not subject to copyright, is in the public domain, and may be freely used or reproduced without obtaining copyright permission.For information and exceptions regarding use of CDC material please see https://www.cdc.gov/other/agencymaterials.html.
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  • CDC Race and Ethnicity: USRealmHeader
• The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  • Unified Code for Units of Measure (UCUM): AgeObservation, AgeRangeObservation... Show 7 more, ImmunizationActivity, MedicationActivity, PlannedImmunizationActivity, PlannedMedicationActivity, ResultObservation, SocialHistoryObservation and VitalSignObservation
• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  • LOINC: AdvanceDirectiveExistenceObservation, AdvanceDirectiveObservation... Show 22 more, AssessmentScaleObservation, CarePlan, CareTeamTypeObservation, ConsultationNote, DisabilityStatusObservation, DischargeSummary, HistoryandPhysical, IndividualPronounObservation, NoteActivity, NotesSection, OperativeNote, PhysicalExamSection, PlannedProcedure, ProcedureActivityProcedure, ProcedureNote, ProgressNote, ReferralNote, SelfCareActivitiesADLandIADL, TransferSummary, TreatmentInterventionPreference, VitalSignObservation and WoundMeasurementObservation
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  • SNOMED Clinical Terms® (SNOMED CT®): AdvanceDirectiveObservation, AllergyStatusObservation... Show 48 more, AuthorParticipation, CarePlanAct, CareTeamMemberAct, CareTeamOrganizer, CharacteristicsofHomeEnvironment, EncounterActivity, FamilyHistoryObservation, FamilyHistoryOrganizer, HandoffCommunicationParticipants, HealthStatusObservation, ImmunizationActivity, Indication, InstructionActivity, InstructionObservation, LongitudinalCareWoundObservation, MedicationActivity, MentalStatusObservation, NoteActivity, NumberofPressureUlcersObservation, NutritionalStatusObservation, PlannedImmunizationActivity, PlannedMedicationActivity, PlannedProcedure, PreconditionforSubstanceAdministration, PregnancyIntentionInNextYear, PriorityPreference, ProblemObservation, ProblemStatus, ProcedureActivityProcedure, ProductInstance, ProgressTowardGoalObservation, ProvenanceAuthorParticipation, ReactionObservation, ReferralAct, RelatedPersonRelationshipAndNameParticipant, ResultOrganizer, SelfCareActivitiesADLandIADL, SensoryStatus, SeverityObservation, SexObservation, SmokingStatus, SmokingStatusMeaningfulUse, SpecimenCollectionProcedure, SubstanceOrDeviceAllergyIntoleranceObservation, TobaccoUse, USRealmHeader, USRealmHeaderforPatientGeneratedDocument and WoundCharacteristic
• This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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  • DataAbsentReason: SexParameterForClinicalUseObservation
  • Observation Category Codes: ResultObservation
  • Sex Parameter For Clinical Use: SexParameterForClinicalUseObservation
  • diagnosticServiceSectionId: ResultOrganizer
  • ActCode: ResultObservation, ResultOrganizer and USRealmHeader
  • ActMood: CarePlanAct, ImmunizationActivity... Show 11 more, MedicationActivity, MedicationFreeTextSig, NonMedicinalSupplyActivity, NutritionRecommendation, PlannedEncounter, PlannedImmunizationActivity, PlannedInterventionAct, PlannedMedicationActivity, PlannedProcedure, PlannedSupply and ReferralAct
  • ActPriority: ProcedureActivityProcedure and ReferralAct
  • ActReason: ImmunizationNotGivenReason
  • ActRelationshipType: CarePlan
  • ActStatus: AllergyConcernAct, CareTeamMemberAct... Show 16 more, CareTeamOrganizer, DrugMonitoringAct, GoalObservation, HealthConcernAct, ImmunizationActivity, MedicalEquipmentOrganizer, MedicationActivity, MedicationSupplyOrder, NonMedicinalSupplyActivity, ProblemConcernAct, ProcedureActivityProcedure, ReferralAct, ResultObservation, ResultOrganizer, RiskConcernAct and SmokingStatusMeaningfulUse
  • AddressUse: USRealmHeader
  • Confidentiality: USRealmHeader
  • EntityNamePartQualifier: USRealmPatientNamePTNUSFIELDED
  • LanguageAbilityMode: USRealmHeader
  • LanguageAbilityProficiency: USRealmHeader
  • MaritalStatus: USRealmHeader
  • NullFlavor: NoteActivity and NotesSection
  • ObservationInterpretation: ResultObservation
  • ObservationValue: CriticalityObservation
  • ParticipationFunction: USRealmHeaderforPatientGeneratedDocument
  • ParticipationType: USRealmHeader
  • Religious Affiliation: USRealmHeader
  • RoleClass: CarePlan, DischargeSummary, PolicyActivity, ReferralNote and TransferSummary
  • RoleCode: AdvanceDirectiveObservation, CarePlan... Show 6 more, FamilyHistoryOrganizer, PolicyActivity, ProvenanceAuthorParticipation, RelatedPersonRelationshipAndNameParticipant, USRealmHeader and USRealmHeaderforPatientGeneratedDocument
  • TribalEntityUS: TribalAffiliationObservation
  • Media Type: NoteActivity and UnstructuredDocument
• Used by permission of HL7 International, all rights reserved Creative Commons License
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  • US Core Category: PlannedProcedure

Expansion Parameters

Parameter	Value
system-version	SNOMED CT[US]