C-CDA on FHIR, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ccda-on-fhir/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
• JSON
• TTL

Resource Profile: Diagnostic Imaging Report

A Diagnostic Imaging Report (DIR) is a document that contains a consulting specialist's interpretation of image data. It conveys the interpretation to the referring (ordering) physician and becomes part of the patient's medical record. It is for use in Radiology, Endoscopy, Cardiology, and other imaging specialties. Note: this document type overlaps with the FHIR DiagnosticReport resource. Most use cases will want to use the specific resource type, but this document type is still useful for CDA to FHIR conversion and other such use cases.

Usage:

• Examples for this Resource Profile: Composition/Diagnostic-Imaging-Report-Example

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USRealmHeader

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
type	S	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred)
Slices for section		0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code
section:findings_section	S	1..1	BackboneElement	Findings Section
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Functional Status Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
text	S	1..1	Narrative	text
Slices for entry		0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:findings_entry	S	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
section:dicom_object_catalog_section	S	0..1	BackboneElement	DICOM Object Catalog Section
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Dicom Object Catalog Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
text	S	1..1	Narrative	text
Slices for entry		0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:dicom_object_catalog_entry	S	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
section:history_section	S	0..1	BackboneElement	History Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:request_section	S	0..1	BackboneElement	Request Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:current_procedure_descriptions_section	S	0..1	BackboneElement	Current Procedure Descriptions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:prior_procedure_descriptions_section	S	0..1	BackboneElement	Prior Procedure Descriptions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:previous_findings_section	S	0..1	BackboneElement	Previous Findings Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:impressions_section	S	0..1	BackboneElement	Impressions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:recommendations_section	S	0..1	BackboneElement	Impressions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:conclusions_section	S	0..1	BackboneElement	Conclusions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
text	S	1..1	Narrative	Text summary of the section, for human interpretation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
language	S	1..1	code	language Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
versionNumber		0..*	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
version_number_extension	S	0..1	integer	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/VersionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
data_enterer_extension	S	0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/DataEntererExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
informant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	informant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformantExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
information_recipient_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile)	informationRecipient URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformationRecipientExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
participant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	participant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/ParticipantExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
performer_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	performer URL: http://hl7.org/fhir/us/ccda/StructureDefinition/PerformerExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
authorization_extension	S	0..*	Reference(Consent)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/AuthorizationExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
order_extension	S	0..*	Reference(ServiceRequest)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/OrderExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	1..1	Identifier	identifier ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred) ele-1: All FHIR elements must have a @value or children
subject	SΣ	0..1	Reference(US Core Patient Profile | Group)	Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children
encounter	SΣ	0..1	Reference(US Core Encounter Profile)	Context of the Composition ele-1: All FHIR elements must have a @value or children
date	SΣ	1..1	dateTime	date ele-1: All FHIR elements must have a @value or children
author	SΣ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson)	Who and/or what authored the composition ele-1: All FHIR elements must have a @value or children
title	SΣ	1..1	string	Document Title ele-1: All FHIR elements must have a @value or children
Slices for attester		0..*	BackboneElement	Attests to accuracy of composition Slice: Unordered, Open by value:mode ele-1: All FHIR elements must have a @value or children
attester:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children
attester:legal_attester	S	0..1	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: legal
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party ele-1: All FHIR elements must have a @value or children
attester:professional_attester	S	0..*	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: professional
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party ele-1: All FHIR elements must have a @value or children
attester:personal_attester	S	0..*	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: personal
party	S	1..1	Reference(US Core Patient Profile | RelatedPerson)	party ele-1: All FHIR elements must have a @value or children
custodian	SΣ	1..1	Reference(US Core Organization Profile)	custodian ele-1: All FHIR elements must have a @value or children
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
section:findings_section	SC	1..1	BackboneElement	Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	1..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Functional Status Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
text	SC	1..1	Narrative	text ele-1: All FHIR elements must have a @value or children
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
entry:findings_entry	SC	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc. ele-1: All FHIR elements must have a @value or children
section:dicom_object_catalog_section	SC	0..1	BackboneElement	DICOM Object Catalog Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	1..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Dicom Object Catalog Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
text	SC	1..1	Narrative	text ele-1: All FHIR elements must have a @value or children
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
entry:dicom_object_catalog_entry	SC	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc. ele-1: All FHIR elements must have a @value or children
section:history_section	SC	0..1	BackboneElement	History Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:request_section	SC	0..1	BackboneElement	Request Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:current_procedure_descriptions_section	SC	0..1	BackboneElement	Current Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:prior_procedure_descriptions_section	SC	0..1	BackboneElement	Prior Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:previous_findings_section	SC	0..1	BackboneElement	Previous Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:impressions_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:recommendations_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:conclusions_section	SC	0..1	BackboneElement	Conclusions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:legal_attester.mode	required	Fixed Value: legal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:professional_attester.mode	required	Fixed Value: professional http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:personal_attester.mode	required	Fixed Value: personal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.section:findings_section.code	example	Pattern: 121070 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:dicom_object_catalog_section.code	example	Pattern: 121181 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:history_section.code	example	Pattern: 121060 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:request_section.code	example	Pattern: 121062 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:current_procedure_descriptions_section.code	example	Pattern: 121064 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.code	example	Pattern: 121066 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:previous_findings_section.code	example	Pattern: 121068 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:impressions_section.code	example	Pattern: 121072 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:recommendations_section.code	example	Pattern: 121074 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:conclusions_section.code	example	Pattern: 121076 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	1..1	code	language Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber		0..*	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
version_number_extension	S	0..1	integer	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/VersionNumber
data_enterer_extension	S	0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/DataEntererExtension
informant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	informant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformantExtension
information_recipient_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile)	informationRecipient URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformationRecipientExtension
participant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	participant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/ParticipantExtension
performer_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	performer URL: http://hl7.org/fhir/us/ccda/StructureDefinition/PerformerExtension
authorization_extension	S	0..*	Reference(Consent)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/AuthorizationExtension
order_extension	S	0..*	Reference(ServiceRequest)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/OrderExtension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	identifier
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred)
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	0..1	Reference(US Core Patient Profile | Group)	Who and/or what the composition is about
encounter	SΣ	0..1	Reference(US Core Encounter Profile)	Context of the Composition
date	SΣ	1..1	dateTime	date
author	SΣ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson)	Who and/or what authored the composition
title	SΣ	1..1	string	Document Title
Slices for attester		0..*	BackboneElement	Attests to accuracy of composition Slice: Unordered, Open by value:mode
attester:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
attester:legal_attester	S	0..1	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: legal
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party
attester:professional_attester	S	0..*	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: professional
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party
attester:personal_attester	S	0..*	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: personal
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Patient Profile | RelatedPerson)	party
custodian	SΣ	1..1	Reference(US Core Organization Profile)	custodian
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
section:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:findings_section	SC	1..1	BackboneElement	Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Functional Status Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	text
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:findings_entry	SC	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:dicom_object_catalog_section	SC	0..1	BackboneElement	DICOM Object Catalog Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Dicom Object Catalog Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	text
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:dicom_object_catalog_entry	SC	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:history_section	SC	0..1	BackboneElement	History Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:request_section	SC	0..1	BackboneElement	Request Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:current_procedure_descriptions_section	SC	0..1	BackboneElement	Current Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:prior_procedure_descriptions_section	SC	0..1	BackboneElement	Prior Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:previous_findings_section	SC	0..1	BackboneElement	Previous Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:impressions_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:recommendations_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:conclusions_section	SC	0..1	BackboneElement	Conclusions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG
Composition.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:legal_attester.mode	required	Fixed Value: legal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:professional_attester.mode	required	Fixed Value: professional http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:personal_attester.mode	required	Fixed Value: personal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:findings_section.code	example	Pattern: 121070 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:findings_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:findings_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:findings_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:dicom_object_catalog_section.code	example	Pattern: 121181 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:dicom_object_catalog_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:dicom_object_catalog_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:dicom_object_catalog_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:history_section.code	example	Pattern: 121060 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:history_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:history_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:history_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:request_section.code	example	Pattern: 121062 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:request_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:request_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:request_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:current_procedure_descriptions_section.code	example	Pattern: 121064 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:current_procedure_descriptions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:current_procedure_descriptions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:current_procedure_descriptions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.code	example	Pattern: 121066 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:previous_findings_section.code	example	Pattern: 121068 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:previous_findings_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:previous_findings_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:previous_findings_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:impressions_section.code	example	Pattern: 121072 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:impressions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:impressions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:impressions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:recommendations_section.code	example	Pattern: 121074 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:recommendations_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:recommendations_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:recommendations_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:conclusions_section.code	example	Pattern: 121076 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:conclusions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:conclusions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:conclusions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USRealmHeader

Summary

Mandatory: 4 elements(19 nested mandatory elements)
Must-Support: 43 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.section
• The element 1 is sliced based on the value of Composition.section.entry

Differential View

This structure is derived from USRealmHeader

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
type	S	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred)
Slices for section		0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code
section:findings_section	S	1..1	BackboneElement	Findings Section
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Functional Status Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
text	S	1..1	Narrative	text
Slices for entry		0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:findings_entry	S	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
section:dicom_object_catalog_section	S	0..1	BackboneElement	DICOM Object Catalog Section
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Dicom Object Catalog Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
text	S	1..1	Narrative	text
Slices for entry		0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:dicom_object_catalog_entry	S	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
section:history_section	S	0..1	BackboneElement	History Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:request_section	S	0..1	BackboneElement	Request Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:current_procedure_descriptions_section	S	0..1	BackboneElement	Current Procedure Descriptions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:prior_procedure_descriptions_section	S	0..1	BackboneElement	Prior Procedure Descriptions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:previous_findings_section	S	0..1	BackboneElement	Previous Findings Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:impressions_section	S	0..1	BackboneElement	Impressions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:recommendations_section	S	0..1	BackboneElement	Impressions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
text	S	1..1	Narrative	Text summary of the section, for human interpretation
section:conclusions_section	S	0..1	BackboneElement	Conclusions Section
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
text	S	1..1	Narrative	Text summary of the section, for human interpretation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
language	S	1..1	code	language Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
versionNumber		0..*	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
version_number_extension	S	0..1	integer	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/VersionNumber ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
data_enterer_extension	S	0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/DataEntererExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
informant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	informant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformantExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
information_recipient_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile)	informationRecipient URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformationRecipientExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
participant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	participant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/ParticipantExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
performer_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	performer URL: http://hl7.org/fhir/us/ccda/StructureDefinition/PerformerExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
authorization_extension	S	0..*	Reference(Consent)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/AuthorizationExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
order_extension	S	0..*	Reference(ServiceRequest)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/OrderExtension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	1..1	Identifier	identifier ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred) ele-1: All FHIR elements must have a @value or children
subject	SΣ	0..1	Reference(US Core Patient Profile | Group)	Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children
encounter	SΣ	0..1	Reference(US Core Encounter Profile)	Context of the Composition ele-1: All FHIR elements must have a @value or children
date	SΣ	1..1	dateTime	date ele-1: All FHIR elements must have a @value or children
author	SΣ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson)	Who and/or what authored the composition ele-1: All FHIR elements must have a @value or children
title	SΣ	1..1	string	Document Title ele-1: All FHIR elements must have a @value or children
Slices for attester		0..*	BackboneElement	Attests to accuracy of composition Slice: Unordered, Open by value:mode ele-1: All FHIR elements must have a @value or children
attester:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children
attester:legal_attester	S	0..1	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: legal
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party ele-1: All FHIR elements must have a @value or children
attester:professional_attester	S	0..*	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: professional
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party ele-1: All FHIR elements must have a @value or children
attester:personal_attester	S	0..*	BackboneElement	attester ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children Fixed Value: personal
party	S	1..1	Reference(US Core Patient Profile | RelatedPerson)	party ele-1: All FHIR elements must have a @value or children
custodian	SΣ	1..1	Reference(US Core Organization Profile)	custodian ele-1: All FHIR elements must have a @value or children
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
section:findings_section	SC	1..1	BackboneElement	Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	1..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Functional Status Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
text	SC	1..1	Narrative	text ele-1: All FHIR elements must have a @value or children
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
entry:findings_entry	SC	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc. ele-1: All FHIR elements must have a @value or children
section:dicom_object_catalog_section	SC	0..1	BackboneElement	DICOM Object Catalog Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	1..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Dicom Object Catalog Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
text	SC	1..1	Narrative	text ele-1: All FHIR elements must have a @value or children
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
entry:dicom_object_catalog_entry	SC	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc. ele-1: All FHIR elements must have a @value or children
section:history_section	SC	0..1	BackboneElement	History Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:request_section	SC	0..1	BackboneElement	Request Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:current_procedure_descriptions_section	SC	0..1	BackboneElement	Current Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:prior_procedure_descriptions_section	SC	0..1	BackboneElement	Prior Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:previous_findings_section	SC	0..1	BackboneElement	Previous Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:impressions_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:recommendations_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
section:conclusions_section	SC	0..1	BackboneElement	Conclusions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title	S	0..1	string	title ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
text	SC	1..1	Narrative	Text summary of the section, for human interpretation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:legal_attester.mode	required	Fixed Value: legal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:professional_attester.mode	required	Fixed Value: professional http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:personal_attester.mode	required	Fixed Value: personal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.section:findings_section.code	example	Pattern: 121070 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:dicom_object_catalog_section.code	example	Pattern: 121181 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:history_section.code	example	Pattern: 121060 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:request_section.code	example	Pattern: 121062 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:current_procedure_descriptions_section.code	example	Pattern: 121064 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.code	example	Pattern: 121066 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:previous_findings_section.code	example	Pattern: 121068 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:impressions_section.code	example	Pattern: 121072 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:recommendations_section.code	example	Pattern: 121074 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:conclusions_section.code	example	Pattern: 121076 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	USRealmHeader	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	1..1	code	language Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
versionNumber		0..*	string	Version-specific identifier for composition URL: http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber
version_number_extension	S	0..1	integer	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/VersionNumber
data_enterer_extension	S	0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	Extension URL: http://hl7.org/fhir/us/ccda/StructureDefinition/DataEntererExtension
informant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	informant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformantExtension
information_recipient_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile)	informationRecipient URL: http://hl7.org/fhir/us/ccda/StructureDefinition/InformationRecipientExtension
participant_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Patient Profile | RelatedPerson)	participant URL: http://hl7.org/fhir/us/ccda/StructureDefinition/ParticipantExtension
performer_extension	S	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	performer URL: http://hl7.org/fhir/us/ccda/StructureDefinition/PerformerExtension
authorization_extension	S	0..*	Reference(Consent)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/AuthorizationExtension
order_extension	S	0..*	Reference(ServiceRequest)	authorization URL: http://hl7.org/fhir/us/ccda/StructureDefinition/OrderExtension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	identifier
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	Diagnostic Imaging Report Binding: LOINC Imaging Document Codes (preferred)
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	0..1	Reference(US Core Patient Profile | Group)	Who and/or what the composition is about
encounter	SΣ	0..1	Reference(US Core Encounter Profile)	Context of the Composition
date	SΣ	1..1	dateTime	date
author	SΣ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | PractitionerRole | US Core Patient Profile | Device | RelatedPerson)	Who and/or what authored the composition
title	SΣ	1..1	string	Document Title
Slices for attester		0..*	BackboneElement	Attests to accuracy of composition Slice: Unordered, Open by value:mode
attester:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
attester:legal_attester	S	0..1	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: legal
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party
attester:professional_attester	S	0..*	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: professional
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	party
attester:personal_attester	S	0..*	BackboneElement	attester
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	S	1..1	code	mode Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: personal
time		0..1	dateTime	When the composition was attested
party	S	1..1	Reference(US Core Patient Profile | RelatedPerson)	party
custodian	SΣ	1..1	Reference(US Core Organization Profile)	custodian
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by value:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
section:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:findings_section	SC	1..1	BackboneElement	Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Functional Status Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121070
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	text
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:findings_entry	SC	0..*	Reference(Observation)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:dicom_object_catalog_section	SC	0..1	BackboneElement	DICOM Object Catalog Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	1..1	string	title
code	S	1..1	CodeableConcept	Dicom Object Catalog Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121181
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	text
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	entry Slice: Unordered, Open by profile:resolve()
entry:dicom_object_catalog_entry	SC	0..*	Reference(ImagingStudy)	This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:history_section	SC	0..1	BackboneElement	History Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121060
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:request_section	SC	0..1	BackboneElement	Request Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121062
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:current_procedure_descriptions_section	SC	0..1	BackboneElement	Current Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121064
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:prior_procedure_descriptions_section	SC	0..1	BackboneElement	Prior Procedure Descriptions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121066
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:previous_findings_section	SC	0..1	BackboneElement	Previous Findings Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121068
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:impressions_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121072
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:recommendations_section	SC	0..1	BackboneElement	Impressions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121074
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:conclusions_section	SC	0..1	BackboneElement	Conclusions Section cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title	S	0..1	string	title
code	S	1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 121076
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	SC	1..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	LOINCImagingDocumentCodes http://hl7.org/fhir/us/ccda/ValueSet/1.3.6.1.4.1.12009.10.2.5 from this IG
Composition.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:legal_attester.mode	required	Fixed Value: legal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:professional_attester.mode	required	Fixed Value: professional http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.attester:personal_attester.mode	required	Fixed Value: personal http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:findings_section.code	example	Pattern: 121070 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:findings_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:findings_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:findings_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:dicom_object_catalog_section.code	example	Pattern: 121181 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:dicom_object_catalog_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:dicom_object_catalog_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:dicom_object_catalog_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:history_section.code	example	Pattern: 121060 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:history_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:history_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:history_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:request_section.code	example	Pattern: 121062 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:request_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:request_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:request_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:current_procedure_descriptions_section.code	example	Pattern: 121064 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:current_procedure_descriptions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:current_procedure_descriptions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:current_procedure_descriptions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.code	example	Pattern: 121066 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:prior_procedure_descriptions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:previous_findings_section.code	example	Pattern: 121068 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:previous_findings_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:previous_findings_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:previous_findings_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:impressions_section.code	example	Pattern: 121072 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:impressions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:impressions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:impressions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:recommendations_section.code	example	Pattern: 121074 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:recommendations_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:recommendations_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:recommendations_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:conclusions_section.code	example	Pattern: 121076 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:conclusions_section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:conclusions_section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:conclusions_section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:findings_section, Composition.section:dicom_object_catalog_section, Composition.section:history_section, Composition.section:request_section, Composition.section:current_procedure_descriptions_section, Composition.section:prior_procedure_descriptions_section, Composition.section:previous_findings_section, Composition.section:impressions_section, Composition.section:recommendations_section, Composition.section:conclusions_section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USRealmHeader

Summary

Mandatory: 4 elements(19 nested mandatory elements)
Must-Support: 43 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.section
• The element 1 is sliced based on the value of Composition.section.entry