Advance Healthcare Directive Interoperability (cda-adi)
0.1.0 - ci-build

Advance Healthcare Directive Interoperability (cda-adi), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cda-adi/ and changes regularly. See the Directory of published versions

Logical Model: Additional Order Entry

Official URL: http://hl7.org/cda/us/adi/StructureDefinition/AdditionalOrderEntry Version: 0.1.0
Active as of 2026-06-19 Computable Name: Additional_Order_Entry
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.9.275.3.3:2026-08-28

This entry is an act in moodCode RQO. In FHIR this expresses a ServiceRequest with an intent of a directive. Each entry includes only a single procedures (with moodCode RQO) for the person as a portable medical order. If the order is to NOT perform the procedure, then negationInd will be true for the procedure. In FHIR this aligns with use of the doNotPerform element.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Template Content

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

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:additional-order 1..1 II
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Fixed Value: RQO
... code
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
... text 0..1 ED links to the rendering of the portable medical order
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
... statusCode 1..1 CS
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
... effectiveTime 1..1 IVL_TS
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... observation S 1..1 InstructionObservation
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... observation S 1..1 GoalObservation
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
... realmCode 0..* CS
... typeId C 0..1 II Constraints: II-1
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @assigningAuthorityName 0..1 st(2.0.3-sd)
.... @displayable 0..1 bl(2.0.3-sd)
.... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st(2.0.3-sd)
.... templateId:additional-order 1..1 II
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... @assigningAuthorityName 0..1 st(2.0.3-sd)
..... @displayable 0..1 bl(2.0.3-sd)
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: RQO
... @negationInd 0..1 bl(2.0.3-sd)
... id 1..* II
... code 1..1 CD Binding: ActCode (3.0.0) (example)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
.... @codeSystem 0..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd)
.... @codeSystemName 0..1 st(2.0.3-sd)
.... @codeSystemVersion 0..1 st(2.0.3-sd)
.... @displayName 0..1 st(2.0.3-sd)
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED links to the rendering of the portable medical order
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @compression 0..1 cs(2.0.3-sd) Binding: CDACompressionAlgorithm (2.0.3-sd) (required)
.... @integrityCheck 0..1 bin(2.0.3-sd)
.... @integrityCheckAlgorithm 0..1 cs(2.0.3-sd) Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs(2.0.3-sd)
.... @mediaType 0..1 cs(2.0.3-sd) Binding: MediaType (3.0.0) (example)
.... @representation 0..1 cs(2.0.3-sd) Binding: BinaryDataEncoding (2.0.3-sd) (required)
.... xmlText 0..1 st(2.0.3-sd) Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
.... thumbnail C 0..1 ED Constraints: ED-1
... statusCode 1..1 CS Binding: ActStatus (3.0.0) (required)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (3.0.0) (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 InstructionObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 GoalObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Act.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.templateId:additional-order.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
Act.code Base example v3 Code System ActCode 📍3.0.0 THO v7.1
Act.code.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.compression Base required CDACompressionAlgorithm 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
Act.text.mediaType Base example MediaType 📍3.0.0 THO v7.1
Act.text.representation Base required CDABinaryDataEncoding 📍2.0.3-sd Clinical Document Architecture v2.0
Act.statusCode Base required ActStatus 📍3.0.0 THO v7.1
Act.statusCode.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.priorityCode Base example ActPriority 📍3.0.0 THO v7.1
Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
Act.entryRelationship:planned-procedure-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:clinical-instruction-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:goal-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
II-1 error Act.typeId, Act.entryRelationship:planned-procedure-part.typeId, Act.entryRelationship:clinical-instruction-part.typeId, Act.entryRelationship:goal-part.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
... realmCode 0..* CS
... typeId C 0..1 II Constraints: II-1
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @assigningAuthorityName 0..1 st(2.0.3-sd)
.... @displayable 0..1 bl(2.0.3-sd)
.... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st(2.0.3-sd)
.... templateId:additional-order 1..1 II
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... @assigningAuthorityName 0..1 st(2.0.3-sd)
..... @displayable 0..1 bl(2.0.3-sd)
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: RQO
... @negationInd 0..1 bl(2.0.3-sd)
... id 1..* II
... code 1..1 CD Binding: ActCode (3.0.0) (example)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
.... @codeSystem 0..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd)
.... @codeSystemName 0..1 st(2.0.3-sd)
.... @codeSystemVersion 0..1 st(2.0.3-sd)
.... @displayName 0..1 st(2.0.3-sd)
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED links to the rendering of the portable medical order
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @compression 0..1 cs(2.0.3-sd) Binding: CDACompressionAlgorithm (2.0.3-sd) (required)
.... @integrityCheck 0..1 bin(2.0.3-sd)
.... @integrityCheckAlgorithm 0..1 cs(2.0.3-sd) Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs(2.0.3-sd)
.... @mediaType 0..1 cs(2.0.3-sd) Binding: MediaType (3.0.0) (example)
.... @representation 0..1 cs(2.0.3-sd) Binding: BinaryDataEncoding (2.0.3-sd) (required)
.... xmlText 0..1 st(2.0.3-sd) Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
.... thumbnail C 0..1 ED Constraints: ED-1
... statusCode 1..1 CS Binding: ActStatus (3.0.0) (required)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (3.0.0) (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 InstructionObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 GoalObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Act.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.templateId:additional-order.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
Act.code Base example v3 Code System ActCode 📍3.0.0 THO v7.1
Act.code.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.compression Base required CDACompressionAlgorithm 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
Act.text.mediaType Base example MediaType 📍3.0.0 THO v7.1
Act.text.representation Base required CDABinaryDataEncoding 📍2.0.3-sd Clinical Document Architecture v2.0
Act.statusCode Base required ActStatus 📍3.0.0 THO v7.1
Act.statusCode.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.priorityCode Base example ActPriority 📍3.0.0 THO v7.1
Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
Act.entryRelationship:planned-procedure-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:clinical-instruction-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:goal-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
II-1 error Act.typeId, Act.entryRelationship:planned-procedure-part.typeId, Act.entryRelationship:clinical-instruction-part.typeId, Act.entryRelationship:goal-part.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

This structure is derived from Act

Summary

Mandatory: 7 elements(3 nested mandatory elements)
Must-Support: 8 elements
Fixed: 8 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 2 is sliced based on the values of Act.templateId
  • The element 2 is sliced based on the values of Act.entryRelationship

Differential View

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
.... templateId:additional-order 1..1 II
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Fixed Value: RQO
... code
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
... text 0..1 ED links to the rendering of the portable medical order
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
... statusCode 1..1 CS
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
... effectiveTime 1..1 IVL_TS
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... observation S 1..1 InstructionObservation
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @typeCode 1..1 cs(2.0.3-sd) Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... observation S 1..1 GoalObservation
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
... realmCode 0..* CS
... typeId C 0..1 II Constraints: II-1
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @assigningAuthorityName 0..1 st(2.0.3-sd)
.... @displayable 0..1 bl(2.0.3-sd)
.... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st(2.0.3-sd)
.... templateId:additional-order 1..1 II
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... @assigningAuthorityName 0..1 st(2.0.3-sd)
..... @displayable 0..1 bl(2.0.3-sd)
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: RQO
... @negationInd 0..1 bl(2.0.3-sd)
... id 1..* II
... code 1..1 CD Binding: ActCode (3.0.0) (example)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
.... @codeSystem 0..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd)
.... @codeSystemName 0..1 st(2.0.3-sd)
.... @codeSystemVersion 0..1 st(2.0.3-sd)
.... @displayName 0..1 st(2.0.3-sd)
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED links to the rendering of the portable medical order
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @compression 0..1 cs(2.0.3-sd) Binding: CDACompressionAlgorithm (2.0.3-sd) (required)
.... @integrityCheck 0..1 bin(2.0.3-sd)
.... @integrityCheckAlgorithm 0..1 cs(2.0.3-sd) Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs(2.0.3-sd)
.... @mediaType 0..1 cs(2.0.3-sd) Binding: MediaType (3.0.0) (example)
.... @representation 0..1 cs(2.0.3-sd) Binding: BinaryDataEncoding (2.0.3-sd) (required)
.... xmlText 0..1 st(2.0.3-sd) Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
.... thumbnail C 0..1 ED Constraints: ED-1
... statusCode 1..1 CS Binding: ActStatus (3.0.0) (required)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (3.0.0) (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 InstructionObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 GoalObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Act.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.templateId:additional-order.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
Act.code Base example v3 Code System ActCode 📍3.0.0 THO v7.1
Act.code.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.compression Base required CDACompressionAlgorithm 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
Act.text.mediaType Base example MediaType 📍3.0.0 THO v7.1
Act.text.representation Base required CDABinaryDataEncoding 📍2.0.3-sd Clinical Document Architecture v2.0
Act.statusCode Base required ActStatus 📍3.0.0 THO v7.1
Act.statusCode.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.priorityCode Base example ActPriority 📍3.0.0 THO v7.1
Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
Act.entryRelationship:planned-procedure-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:clinical-instruction-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:goal-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
II-1 error Act.typeId, Act.entryRelationship:planned-procedure-part.typeId, Act.entryRelationship:clinical-instruction-part.typeId, Act.entryRelationship:goal-part.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Act C 1..1 Act(2.0.3-sd) XML Namespace: urn:hl7-org:v3
Base for all types and resources
Instance of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
Constraints: should-text-ref-value
... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
... realmCode 0..* CS
... typeId C 0..1 II Constraints: II-1
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @assigningAuthorityName 0..1 st(2.0.3-sd)
.... @displayable 0..1 bl(2.0.3-sd)
.... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1 st(2.0.3-sd)
.... templateId:additional-order 1..1 II
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... @assigningAuthorityName 0..1 st(2.0.3-sd)
..... @displayable 0..1 bl(2.0.3-sd)
..... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Required Pattern: 2.16.840.1.113883.9.275.3.3
..... @extension 1..1 st(2.0.3-sd) Required Pattern: 2026-08-28
... @classCode 1..1 cs(2.0.3-sd) Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: ACT
... @moodCode 1..1 cs(2.0.3-sd) Binding: XDocumentActMood (2.0.0) (required)
Fixed Value: RQO
... @negationInd 0..1 bl(2.0.3-sd)
... id 1..* II
... code 1..1 CD Binding: ActCode (3.0.0) (example)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: 100824-2
.... @codeSystem 0..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd)
.... @codeSystemName 0..1 st(2.0.3-sd)
.... @codeSystemVersion 0..1 st(2.0.3-sd)
.... @displayName 0..1 st(2.0.3-sd)
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1 ED
.... qualifier 0..* CR
.... translation 0..* CD
... text 0..1 ED links to the rendering of the portable medical order
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @compression 0..1 cs(2.0.3-sd) Binding: CDACompressionAlgorithm (2.0.3-sd) (required)
.... @integrityCheck 0..1 bin(2.0.3-sd)
.... @integrityCheckAlgorithm 0..1 cs(2.0.3-sd) Binding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1 cs(2.0.3-sd)
.... @mediaType 0..1 cs(2.0.3-sd) Binding: MediaType (3.0.0) (example)
.... @representation 0..1 cs(2.0.3-sd) Binding: BinaryDataEncoding (2.0.3-sd) (required)
.... xmlText 0..1 st(2.0.3-sd) Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C 0..1 TEL Constraints: value-starts-octothorpe
.... thumbnail C 0..1 ED Constraints: ED-1
... statusCode 1..1 CS Binding: ActStatus (3.0.0) (required)
.... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
.... @code 0..1 cs(2.0.3-sd) Required Pattern: active
.... @sdtcValueSet 0..1 oid(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st(2.0.3-sd) XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS
... priorityCode 0..1 CE Binding: ActPriority (3.0.0) (example)
... languageCode 0..1 CS Binding: AllLanguages (required)
... subject 0..1 Subject
... specimen 0..* Specimen
... performer 0..* Performer2
... author 0..* Author
... informant 0..* Informant
... participant 0..* Participant2
... Slices for entryRelationship S 0..* EntryRelationship Slice: Unordered, Open by profile:observation, profile:procedure
.... entryRelationship:planned-procedure-part S 0..1 EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation 0..1 Observation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure S 1..1 Additional_Order_Planned_Procedure_Part
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:clinical-instruction-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 InstructionObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
.... entryRelationship:goal-part S 0..* EntryRelationship
..... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
..... realmCode 0..* CS
..... typeId C 0..1 II Constraints: II-1
...... @nullFlavor 0..1 cs(2.0.3-sd) Binding: CDANullFlavor (2.0.3-sd) (required)
...... @assigningAuthorityName 0..1 st(2.0.3-sd)
...... @displayable 0..1 bl(2.0.3-sd)
...... @root 1..1 oid(2.0.3-sd), uuid(2.0.3-sd), ruid(2.0.3-sd) Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st(2.0.3-sd)
..... templateId 0..* II
..... @typeCode 1..1 cs(2.0.3-sd) Binding: XActRelationshipEntryRelationship (3.0.0) (required)
Fixed Value: COMP
..... @inversionInd 0..1 bl(2.0.3-sd) Fixed Value: false
..... @contextConductionInd 0..1 bl(2.0.3-sd)
..... @negationInd 0..1 bl(2.0.3-sd)
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation S 1..1 GoalObservation
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition S 0..1 Precondition Expresses the precondition in an order that is conditional upon a certain health scenario.
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Act.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.templateId:additional-order.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
Act.code Base example v3 Code System ActCode 📍3.0.0 THO v7.1
Act.code.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.compression Base required CDACompressionAlgorithm 📍2.0.3-sd Clinical Document Architecture v2.0
Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
Act.text.mediaType Base example MediaType 📍3.0.0 THO v7.1
Act.text.representation Base required CDABinaryDataEncoding 📍2.0.3-sd Clinical Document Architecture v2.0
Act.statusCode Base required ActStatus 📍3.0.0 THO v7.1
Act.statusCode.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.priorityCode Base example ActPriority 📍3.0.0 THO v7.1
Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
Act.entryRelationship:planned-procedure-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:clinical-instruction-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1
Act.entryRelationship:goal-part.​nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor Base required CDANullFlavor 📍2.0.3-sd Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode Base required x_ActRelationshipEntryRelationship 📍3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
II-1 error Act.typeId, Act.entryRelationship:planned-procedure-part.typeId, Act.entryRelationship:clinical-instruction-part.typeId, Act.entryRelationship:goal-part.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

This structure is derived from Act

Summary

Mandatory: 7 elements(3 nested mandatory elements)
Must-Support: 8 elements
Fixed: 8 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 2 is sliced based on the values of Act.templateId
  • The element 2 is sliced based on the values of Act.entryRelationship

 

Other representations of profile: CSV, Excel