Validation Results for CCDA

Generated Thu Jun 05 17:34:50 UTC 2025, FHIR version 5.0.0 for hl7.cda.us.ccda#4.0.0 (canonical = http://hl7.org/cda/us/ccda (history)). See Full QA Report & IP

Quality Checks
Publisher Version:IG Publisher Version: v2.0.5
Publication Code:n/a . PackageId = hl7.cda.us.ccda, Canonical = http://hl7.org/cda/us/ccda
Realm Check for n/a:
  • n/a
Language Info:This IG has no language information
Publication Request:
package-idhl7.cda.us.ccda
version4.0.0
pathhttp://hl7.org/cda/us/ccda/4.0.0
Pub-Modemilestone
statustrial-use
Release-LabelSTU4
Sequence (Group)CCDA 4.0 (current: 'CCDA 3.0', others = 'CCDA 2.1','CCDA 4.0')
descPublished version of C-CDA 4.0. This release enables exchange of USCDI v5.
RelatedIgs(None Found)
No Messages found - all good
Supressed Messages:103 Suppressed Issues
Dependency Checks:
PackageVersionFHIRCanonicalWeb BaseComment
.. hl7.cda.us.ccda4.0.0R5http://hl7.org/cda/us/ccda
... hl7.terminology.r56.4.0 MR5http://terminology.hl7.orghttp://terminology.hl7.org/6.4.0
.... hl7.fhir.uv.extensions.r55.2.0 MR5http://hl7.org/fhir/extensionshttp://hl7.org/fhir/extensions/5.2.0
... hl7.fhir.uv.extensions.r55.2.0 MR5http://hl7.org/fhir/extensionshttp://hl7.org/fhir/extensions/5.2.0see above
... hl7.cda.uv.core2.0.1-sd MR5http://hl7.org/cda/stds/corehttp://hl7.org/cda/stds/core/2.0.1-sd
.... hl7.fhir.uv.extensions.r55.1.0 OR5http://hl7.org/fhir/extensionshttp://hl7.org/fhir/extensions/5.1.0Latest Release is 5.2.0
.... hl7.terminology5.2.0 OR4http://terminology.hl7.orghttp://terminology.hl7.org/5.2.0FHIR Version Mismatch. Latest Release is 6.4.0
..... hl7.fhir.uv.extensions.r41.0.0 OR4http://hl7.org/fhir/extensionshttp://hl7.org/fhir/extensions/1.0.0FHIR Version Mismatch. Latest Release is 5.2.0
... us.cdc.phinvads0.12.0 MR4http://fhir.org/packages/us.cdc.phinvadshttp://fhir.org/packages/us.cdc.phinvadsFHIR Version Mismatch
... hl7.fhir.us.core8.0.0-ballot IR4http://hl7.org/fhir/us/corehttp://hl7.org/fhir/us/core/2025JanFHIR Version Mismatch
.... hl7.terminology.r46.1.0 OR4http://terminology.hl7.orghttp://terminology.hl7.org/6.1.0FHIR Version Mismatch. Latest Release is 6.4.0
.... hl7.fhir.uv.smart-app-launch2.0.0 OR4http://hl7.org/fhir/smart-app-launchhttp://hl7.org/fhir/smart-app-launch/STU2FHIR Version Mismatch. Latest Release is 2.2.0
.... us.nlm.vsac0.21.0 OR4http://fhir.org/packages/us.nlm.vsachttp://fhir.org/packages/us.nlm.vsacFHIR Version Mismatch. Latest Release is 0.23.0
.... hl7.fhir.uv.sdc3.0.0 MR4http://hl7.org/fhir/uv/sdchttp://hl7.org/fhir/uv/sdc/STU3FHIR Version Mismatch
..... hl7.fhir.r4.examples4.0.1 OR4http://hl7.org/fhirhttp://hl7.org/fhir/R4FHIR Version Mismatch. Latest Release is 5.0.0
.... us.cdc.phinvads0.12.0 MR4http://fhir.org/packages/us.cdc.phinvadshttp://fhir.org/packages/us.cdc.phinvadssee above
.... hl7.fhir.uv.extensions.r45.1.0 OR4http://hl7.org/fhir/extensionshttp://hl7.org/fhir/extensions/5.1.0FHIR Version Mismatch. Latest Release is 5.2.0
Templates: hl7.cda.template#current -> hl7.base.template#current -> fhir.base.template#current. Tools: 0.5.0
Related IGs:n/a
Dependent IGs:no references
Global Profiles:(none declared)
Terminology Server(s):http://tx.fhir.org/r5, https://tx.fhir.org/r5 (details)
HTA Analysis:no Non-HL7 references found
R5 Dependencies:(none)
Draft Dependencies:
Modifier Extensions:(none)
Previous Version Comparison: Comparison with version 4.0.0-ballot
IPA Comparison: n/a
IPS Comparison: n/a
Validation Flags: On: autoLoad; Off: hintAboutNonMustSupport, anyExtensionsAllowed, checkAggregation, showReferenceMessages, noExperimentalContent, displayWarnings
Summary: errors = 21, warn = 3, info = 12, broken links = 0, pinned = n/a.
FilenameErrorsWarningsHints
Build Errors000
/scratch/repo/input/examples/basic-industry-observation-example100
/scratch/repo/input/examples/basic-occupation-observation-example100
/scratch/repo/input/examples/care-team-member-schedule-observation-example100
/scratch/repo/input/examples/care-team-organizer-example100
/scratch/repo/input/examples/comment-activity-example100
/scratch/repo/input/examples/medication-free-text-sig-example100
/scratch/repo/input/examples/us-realm-address-example100
/scratch/repo/input/examples/us-realm-date-and-time-example100
/scratch/repo/input/examples/us-realm-date-and-time-ivl-example100
/scratch/repo/input/hl7.cda.us.ccda1230

n/a Show Validation Information

warningThis IG is for FHIR version 5.0.0, while the package 'hl7.terminology#5.2.0' is for FHIR version 4.0.1
warningThis IG is version 5.0.0, while the IG 'us.nlm.vsac' is from version 4.0.1
warningThis IG is version 5.0.0, while the IG 'us.cdc.phinvads' is from version 4.0.1
warningThis IG is version 5.0.0, while the IG 'hl7.fhir.us.core' is from version 4.0.1

input/examples/basic-industry-observation-example.xml Show Validation Information (2)

PathSeverityMessage
observation.value[0] (l21/c70)errorNone of the codings provided are in the value set 'Industry NAICS Detail (ODH)' (http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7900|1), and a coding from this value set is required) (codes = http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH#811111.001118)

Editor's Comment: 22 Different example code systems that have no codes so can not be validated Terminology_TX_NoValid_1_CC

input/examples/basic-occupation-observation-example.xml Show Validation Information (2)

PathSeverityMessage
observation.value[0] (l23/c70)errorNone of the codings provided are in the value set 'Occupation ONETSOC Detail (ODH)' (http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7901|1), and a coding from this value set is required) (codes = http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH#51-9191.00.002682)

Editor's Comment: 22 Different example code systems that have no codes so can not be validated Terminology_TX_NoValid_1_CC

input/examples/care-team-member-schedule-observation-example.xml Show Validation Information (1)

PathSeverityMessage
observation.text (l6/c8)errorObservation.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CareTeamMemberScheduleObservation|4.0.0)

Editor's Comment: v4-03 - Text reference requires a URL but we don't have resolvable URLs. Validation_VAL_Profile_Minimum

input/examples/care-team-organizer-example.xml Show Validation Information (1)

PathSeverityMessage
organizer.code.originalText (l8/c17)errorOrganizer.code.originalText.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CareTeamOrganizer|4.0.0)

Editor's Comment: v4-03 - Text reference requires a URL but we don't have resolvable URLs. Validation_VAL_Profile_Minimum

input/examples/comment-activity-example.xml Show Validation Information (1)

PathSeverityMessage
act.text (l6/c9)errorAct.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CommentActivity|4.0.0)

Editor's Comment: v4-03 - Text reference requires a URL but we don't have resolvable URLs. Validation_VAL_Profile_Minimum

input/examples/medication-free-text-sig-example.xml Show Validation Information (1)

PathSeverityMessage
substanceAdministration.text (l8/c9)errorSubstanceAdministration.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/MedicationFreeTextSig|4.0.0)

Editor's Comment: v4-03 - Text reference requires a URL but we don't have resolvable URLs. Validation_VAL_Profile_Minimum

input/examples/us-realm-address-example.xml Show Validation Information (0)

PathSeverityMessage
addr (l1/c39)fatalThe QName 'urn:hl7-org:v3::addr' does not match the expected QName 'urn:hl7-org:v3::AD'

Editor's Comment: 24 ERROR - our examples use an element that makes sense but does not match the actual datatype name

input/examples/us-realm-date-and-time-example.xml Show Validation Information (0)

PathSeverityMessage
time (l3/c48)fatalThe QName 'urn:hl7-org:v3::time' does not match the expected QName 'urn:hl7-org:v3::TS'

Editor's Comment: 24 ERROR - our examples use an element that makes sense but does not match the actual datatype name

input/examples/us-realm-date-and-time-ivl-example.xml Show Validation Information (0)

PathSeverityMessage
effectiveTime (l2/c39)fatalThe QName 'urn:hl7-org:v3::effectiveTime' does not match the expected QName 'urn:hl7-org:v3::IVL_TS'

Editor's Comment: 24 ERROR - our examples use an element that makes sense but does not match the actual datatype name

input/hl7.cda.us.ccda.xml Show Validation Information (1)

PathSeverityMessage
ImplementationGuide​.definition​.resource[256]​.reference (l1​/c131016)errorUnable to resolve resource with reference 'Binary/care-plan-complete-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[270]​.reference (l1​/c140904)errorUnable to resolve resource with reference 'Binary/ccd-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[274]​.reference (l1​/c143804)errorUnable to resolve resource with reference 'Binary/consultation-note-complete-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[289]​.reference (l1​/c154378)errorUnable to resolve resource with reference 'Binary/discharge-summary-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[320]​.reference (l1​/c176070)errorUnable to resolve resource with reference 'Binary/history-and-physical-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[372]​.reference (l1​/c212813)errorUnable to resolve resource with reference 'Binary/operative-note-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[386]​.reference (l1​/c223051)errorUnable to resolve resource with reference 'Binary/patient-generated-document-informationrecipient'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[417]​.reference (l1​/c244880)errorUnable to resolve resource with reference 'Binary/procedure-note-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[432]​.reference (l1​/c255488)errorUnable to resolve resource with reference 'Binary/progress-note-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[442]​.reference (l1​/c262524)errorUnable to resolve resource with reference 'Binary/referral-note-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[471]​.reference (l1​/c282761)errorUnable to resolve resource with reference 'Binary/transfer-summary-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.definition​.resource[479]​.reference (l1​/c288360)errorUnable to resolve resource with reference 'Binary/us-realm-header-example'

Editor's Comment: 25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference Reference_REF_CantResolve
ImplementationGuide​.dependsOn[3] (l1​/c2004)warningThe ImplementationGuide is based on FHIR version 5.0.0 but package us.nlm.vsac#0.23.0 is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try IG_DEPENDENCY_VERSION_WARNING
ImplementationGuide​.dependsOn[4] (l1​/c2150)warningThe ImplementationGuide is based on FHIR version 5.0.0 but package us.cdc.phinvads#0.12.0 is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try IG_DEPENDENCY_VERSION_WARNING
ImplementationGuide​.dependsOn[5] (l1​/c2295)warningThe ImplementationGuide is based on FHIR version 5.0.0 but package hl7.fhir.us.core#8.0.0-ballot is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try IG_DEPENDENCY_VERSION_WARNING

Suppressed Messages (Warnings, hints, broken links)

01 CDA Schematron generation parameters that are noted as unknown by the IG publisher

02 Deliberate decision around fixed/pattern which results in warnings

03 IG Publisher issue - Grahame to fix: https://chat.fhir.org/#narrow/stream/198221-cda.2Fpublish/topic/Invariant.20expression.20error

04 Inherent collections where collection is limited to a single value so the warning is fine

05 Deprecated value set that is used by CDA and inherited by C-CDA

06 xsi:type information - firing on templates with constrained type, but still required in CDA

08 Each slice is optional, so the maximum still applies

11 These are template IDs that are embedded in other templates and are not an individual template. The validator can not find these templates and warns us about them.

12 Our examples may not enforce the text references

13 Our examples will not always contain an author

14 Multiple template IDs are required so the validator throws a warning on the slices

15 In the example the OID matches two different code systems - nothing we can do about this in the guide itself.

16 Assigned Author slices that are detected multiple times

17 An extra element not specified by the template

18 Note Activity is not a defined slice in the template but can be included

19 Goal Observation is not a defined slice in the template but can be included

20 Template requires a retired code

21 Unknown code systems used in examples

22 Different example code systems that have no codes so can not be validated

23 SHOULD constraints that we are intentionally not including

24 ERROR - our examples use an element that makes sense but does not match the actual datatype name

25 ERROR the full document examples are there and do get validated but the validator is unable to resolve reference

27 Duplicate anchor ids produced by publisher - see if this can be fixed in a future release of the template

28 Experimental value sets in THO

31 Multiple version matches for values sets - should choose specific version

v4-01 - referencing an example external document that doesn't exist

v4-02 - We know that Languages is a proper subset of all-languages

v4-03 - Text reference requires a URL but we don't have resolvable URLs.

Errors sorted by type


Details_for__matching_against_Profile_

input/examples/advance-directives-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectivesSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/allergy-to-food-egg.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/AllergiesAndIntolerancesSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/disability-status-observation-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/DisabilityStatusObservation|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/mental-status-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/MentalStatusSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/no-known-problems-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/ProblemSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/progress-note-header-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/NotesSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/results-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/ResultsSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/sensory-and-speech-status-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/SensoryStatus|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/vital-signs-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/VitalSignsSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)
input/examples/vital-signs-section-example.xmlThis element does not match any known slice defined in the profile http://hl7.org/cda/us/ccda/StructureDefinition/VitalSignsSection|4.0.0 (this may not be a problem, but you should check that it's not intended to match a slice)

IG_DEPENDENCY_VERSION_WARNING

input/hl7.cda.us.ccda.xmlThe ImplementationGuide is based on FHIR version 5.0.0 but package us.nlm.vsac#0.23.0 is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try
input/hl7.cda.us.ccda.xmlThe ImplementationGuide is based on FHIR version 5.0.0 but package us.cdc.phinvads#0.12.0 is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try
input/hl7.cda.us.ccda.xmlThe ImplementationGuide is based on FHIR version 5.0.0 but package hl7.fhir.us.core#8.0.0-ballot is based on FHIR version 4.0.1. In general, this version mismatch should be avoided - some tools will try to make this work with variable degrees of success, but others will not even try

MSG_DEPENDS_ON_RETIRED

input/resources/StructureDefinition-HealthConcernAct.xmlThe profile http://hl7.org/cda/us/ccda/StructureDefinition/SmokingStatusMeaningfulUse|4.0.0 is retired
input/resources/StructureDefinition-HealthConcernAct.xmlThe profile http://hl7.org/cda/us/ccda/StructureDefinition/TobaccoUse|4.0.0 is retired

Reference_REF_CantResolve

input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/care-plan-complete-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/ccd-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/consultation-note-complete-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/discharge-summary-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/history-and-physical-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/operative-note-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/patient-generated-document-informationrecipient'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/procedure-note-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/progress-note-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/referral-note-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/transfer-summary-header-example'
input/hl7.cda.us.ccda.xmlUnable to resolve resource with reference 'Binary/us-realm-header-example'

Terminology_TX_NoValid_1_CC

input/examples/basic-industry-observation-example.xmlNone of the codings provided are in the value set 'Industry NAICS Detail (ODH)' (http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7900|1), and a coding from this value set is required) (codes = http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH#811111.001118)
input/examples/basic-occupation-observation-example.xmlNone of the codings provided are in the value set 'Occupation ONETSOC Detail (ODH)' (http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7901|1), and a coding from this value set is required) (codes = http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH#51-9191.00.002682)

Validation_VAL_Profile_Minimum

input/examples/care-team-member-schedule-observation-example.xmlObservation.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CareTeamMemberScheduleObservation|4.0.0)
input/examples/care-team-organizer-example.xmlOrganizer.code.originalText.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CareTeamOrganizer|4.0.0)
input/examples/comment-activity-example.xmlAct.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/CommentActivity|4.0.0)
input/examples/medication-free-text-sig-example.xmlSubstanceAdministration.text.reference: minimum required = 1, but only found 0 (from http://hl7.org/cda/us/ccda/StructureDefinition/MedicationFreeTextSig|4.0.0)