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: External_Entry_Reference_Entry - Detailed Descriptions

Draft as of 2026-06-19

Definitions for the External.Entry.Reference.Entry logical model.

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

0. Act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
2. Act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Act.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
8. Act.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
10. Act.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
12. Act.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
14. Act.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
16. Act.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
18. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control2..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 20. Act.templateId:entry-reference
    Slice Nameentry-reference
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    22. Act.templateId:entry-reference.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    24. Act.templateId:entry-reference.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    26. Act.templateId:entry-reference.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    28. Act.templateId:entry-reference.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.10.20.22.4.122
    30. Act.templateId:entry-reference.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    32. Act.templateId:external-entry-reference
    Slice Nameexternal-entry-reference
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    34. Act.templateId:external-entry-reference.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    36. Act.templateId:external-entry-reference.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    38. Act.templateId:external-entry-reference.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    40. Act.templateId:external-entry-reference.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.4.823.1.4.2.5
    42. Act.templateId:external-entry-reference.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control1..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    Pattern Value2026-08-28
    44. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31485).

    Control1..1
    BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueACT
    46. Act.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31486).

    Control1..1
    BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueEVN
    48. Act.negationInd
    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    50. Act.id
    ShortWhen using a FHIR Collection Bundle for the entries, use the Resource name/Resource id as the id value. For example, if the entry is a FHIR Patient resource with id 123, then the id value would be 'Condition/123'.
    Comments

    MUST contain at least one [1..*] id.

    Control1..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    52. Act.id.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..0
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    54. Act.id.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    56. Act.id.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    58. Act.id.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control0..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    60. Act.id.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    62. Act.code
    Comments

    SHALL contain exactly one [1..1] code (CONF:1098-31490).

    Control1..1
    BindingFor example codes, see ActCode (3.0.0)
    (example to http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    64. Act.code.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Comments

    This code SHALL contain exactly one [1..1] @nullFlavor="NP" Not Present (CodeSystem: HL7NullFlavor urn:oid:2.16.840.1.113883.5.1008) (CONF:1098-31491).

    Control1..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    Fixed ValueNP
    66. Act.code.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    68. Act.code.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    70. Act.code.codeSystemName
    Definition

    The common name of the coding system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    72. Act.code.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    74. Act.code.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    76. Act.code.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    78. Act.code.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    80. Act.code.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    82. Act.code.qualifier
    Definition

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

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    84. Act.code.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    86. Act.text
    Shortlinks to the rendering of the entry information contained in the externally referenced Resource.
    Control0..1
    This element is affected by the following invariants: should-text-ref-value
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    88. Act.text.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    90. Act.text.compression
    Definition

    Indicates whether the raw byte data is compressed, and what compression algorithm was used.

    Control0..1
    BindingThe codes SHALL be taken from CDACompressionAlgorithm (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCompression
    92. Act.text.integrityCheck
    Definition

    The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

    Control0..1
    Typebase64Binary(bin: Binary Data)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check
    94. Act.text.integrityCheckAlgorithm
    Definition

    Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

    Control0..1
    BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check Algorithm
    96. Act.text.language
    Definition

    For character based information the language property specifies the human language of the text.

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelLanguage
    98. Act.text.mediaType
    Definition

    Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

    Control0..1
    BindingFor example codes, see MediaType (3.0.0)
    (example to http://terminology.hl7.org/ValueSet/v3-MediaType|3.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelMedia Type
    100. Act.text.representation
    Control0..1
    BindingThe codes SHALL be taken from BinaryDataEncoding (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    102. Act.text.xmlText
    Definition

    Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

    ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    Comments

    This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as unadorned text.
    104. Act.text.reference
    Definition

    A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    LabelReference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    106. Act.text.thumbnail
    Definition

    An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelThumbnail
    InvariantsED-1: Thumbnails cannot contain their own thumbnails (thumbnail.empty())
    108. Act.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:1098-31498).

    Control1..1
    BindingThe codes SHALL be taken from ActStatus (3.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus|3.0.0)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    110. Act.statusCode.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    112. Act.statusCode.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    ShortMAY be set to "completed"
    Comments

    This statusCode MAY contain zero or one [0..1] @code="completed" (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:1098-31499).

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    114. Act.statusCode.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..0
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    116. Act.statusCode.codeSystemName
    Definition

    The common name of the coding system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    118. Act.statusCode.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    120. Act.statusCode.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    122. Act.statusCode.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    124. Act.statusCode.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    126. Act.statusCode.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    128. Act.statusCode.qualifier
    Definition

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

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    130. Act.statusCode.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    132. Act.effectiveTime
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
    134. Act.priorityCode
    Control0..1
    BindingFor example codes, see ActPriority (3.0.0)
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    136. Act.languageCode
    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    138. Act.subject
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
    140. Act.specimen
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
    142. Act.performer
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
    144. Act.author
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
    146. Act.informant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
    148. Act.participant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
    150. Act.entryRelationship
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
    152. Act.reference
    Comments

    MUST contain exactly one [1..1] reference.

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
    154. Act.reference.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    156. Act.reference.realmCode
    Definition

    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    158. Act.reference.typeId
    Definition

    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
    160. Act.reference.typeId.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    162. Act.reference.typeId.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    164. Act.reference.typeId.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    166. Act.reference.typeId.root
    Definition

    Identifies the type as an HL7 Registered model

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Fixed Value2.16.840.1.113883.1.3
    168. Act.reference.typeId.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control1..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    170. Act.reference.templateId
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    172. Act.reference.typeCode
    Comments

    MUST contain exactly one [1..1] @typeCode="REFR" Reference (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-9026).

    Control1..1
    BindingThe codes SHALL be taken from XActRelationshipExternalReference (3.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference|3.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueREFR
    174. Act.reference.seperatableInd
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
    176. Act.reference.externalAct
    Comments

    Use externalAct to reference any other FHIR Entry Resource.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
    178. Act.reference.externalObservation
    Comments

    Use externalObservation to reference any FHIR Entry Observation Resource.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
    180. Act.reference.externalProcedure
    Comments

    Use externalProcedure to reference any FHIR Entry Procedure Resource.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
    182. Act.reference.externalDocument
    Comments

    Use externalDocument to reference any FHIR DocumentReference EntryResource or Composition Entry Resource.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
    184. Act.precondition
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
    186. Act.sdtcPrecondition2
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
    188. Act.sdtcInFulfillmentOf1
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

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

    0. Act
    Logical ContainerClinicalDocument (CDA Class)
    ValidationInstance of this type are validated by templateId
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
    Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
    2. Act.templateId
    Control2..?
    SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ root
    • value @ extension
    • 4. Act.templateId:external-entry-reference
      Slice Nameexternal-entry-reference
      Control1..1
      6. Act.templateId:external-entry-reference.root
      Control1..?
      Pattern Value2.16.840.1.113883.4.823.1.4.2.5
      8. Act.templateId:external-entry-reference.extension
      Control1..?
      Pattern Value2026-08-28
      10. Act.id
      ShortWhen using a FHIR Collection Bundle for the entries, use the Resource name/Resource id as the id value. For example, if the entry is a FHIR Patient resource with id 123, then the id value would be 'Condition/123'.
      Comments

      MUST contain at least one [1..*] id.

      12. Act.text
      Shortlinks to the rendering of the entry information contained in the externally referenced Resource.
      14. Act.text.reference
      Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
      16. Act.reference
      Comments

      MUST contain exactly one [1..1] reference.

      Control1..1
      18. Act.reference.typeCode
      Comments

      MUST contain exactly one [1..1] @typeCode="REFR" Reference (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-9026).

      Fixed ValueREFR
      20. Act.reference.externalAct
      Comments

      Use externalAct to reference any other FHIR Entry Resource.

      22. Act.reference.externalObservation
      Comments

      Use externalObservation to reference any FHIR Entry Observation Resource.

      24. Act.reference.externalProcedure
      Comments

      Use externalProcedure to reference any FHIR Entry Procedure Resource.

      26. Act.reference.externalDocument
      Comments

      Use externalDocument to reference any FHIR DocumentReference EntryResource or Composition Entry Resource.

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

      0. Act
      Definition

      Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

      ShortBase for all types and resources
      Control1..1
      Is Modifierfalse
      Logical ContainerClinicalDocument (CDA Class)
      ValidationInstance of this type are validated by templateId
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
      Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
      2. Act.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      4. Act.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      6. Act.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      8. Act.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      10. Act.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      12. Act.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      14. Act.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      16. Act.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      18. Act.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control2..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 20. Act.templateId:entry-reference
        Slice Nameentry-reference
        Definition

        When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        22. Act.templateId:entry-reference.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        24. Act.templateId:entry-reference.assigningAuthorityName
        Definition

        A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        26. Act.templateId:entry-reference.displayable
        Definition

        Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        28. Act.templateId:entry-reference.root
        Definition

        A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Pattern Value2.16.840.1.113883.10.20.22.4.122
        30. Act.templateId:entry-reference.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control0..0
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        32. Act.templateId:external-entry-reference
        Slice Nameexternal-entry-reference
        Definition

        When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        34. Act.templateId:external-entry-reference.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        36. Act.templateId:external-entry-reference.assigningAuthorityName
        Definition

        A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        38. Act.templateId:external-entry-reference.displayable
        Definition

        Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        40. Act.templateId:external-entry-reference.root
        Definition

        A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Pattern Value2.16.840.1.113883.4.823.1.4.2.5
        42. Act.templateId:external-entry-reference.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        Pattern Value2026-08-28
        44. Act.classCode
        Comments

        SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31485).

        Control1..1
        BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueACT
        46. Act.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31486).

        Control1..1
        BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueEVN
        48. Act.negationInd
        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        50. Act.id
        ShortWhen using a FHIR Collection Bundle for the entries, use the Resource name/Resource id as the id value. For example, if the entry is a FHIR Patient resource with id 123, then the id value would be 'Condition/123'.
        Comments

        MUST contain at least one [1..*] id.

        Control1..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        52. Act.id.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..0
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        54. Act.id.assigningAuthorityName
        Definition

        A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        56. Act.id.displayable
        Definition

        Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        58. Act.id.root
        Definition

        A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

        Control0..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        60. Act.id.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        62. Act.code
        Comments

        SHALL contain exactly one [1..1] code (CONF:1098-31490).

        Control1..1
        BindingFor example codes, see ActCode (3.0.0)
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        64. Act.code.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Comments

        This code SHALL contain exactly one [1..1] @nullFlavor="NP" Not Present (CodeSystem: HL7NullFlavor urn:oid:2.16.840.1.113883.5.1008) (CONF:1098-31491).

        Control1..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        Fixed ValueNP
        66. Act.code.code
        Definition

        The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

        Control0..1
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode
        68. Act.code.codeSystem
        Definition

        Specifies the code system that defines the code.

        Control0..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System
        70. Act.code.codeSystemName
        Definition

        The common name of the coding system.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System Name
        72. Act.code.codeSystemVersion
        Definition

        If applicable, a version descriptor defined specifically for the given code system.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System Version
        74. Act.code.displayName
        Definition

        A name or title for the code, under which the sending system shows the code value to its users.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplay Name
        76. Act.code.sdtcValueSet
        Definition

        The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

        Control0..1
        Typestring(oid: ISO Object Identifier)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
        78. Act.code.sdtcValueSetVersion
        Definition

        The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
        80. Act.code.originalText
        Definition

        The text or phrase used as the basis for the coding.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        LabelOriginal Text
        82. Act.code.qualifier
        Definition

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

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
        LabelQualifier
        84. Act.code.translation
        Definition

        A set of other concept descriptors that translate this concept descriptor into other code systems.

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        XML FormatThe type of this property is determined using the xsi:typeattribute.
        LabelTranslation
        86. Act.text
        Shortlinks to the rendering of the entry information contained in the externally referenced Resource.
        Control0..1
        This element is affected by the following invariants: should-text-ref-value
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        88. Act.text.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        90. Act.text.compression
        Definition

        Indicates whether the raw byte data is compressed, and what compression algorithm was used.

        Control0..1
        BindingThe codes SHALL be taken from CDACompressionAlgorithm (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCompression
        92. Act.text.integrityCheck
        Definition

        The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

        Control0..1
        Typebase64Binary(bin: Binary Data)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelIntegrity Check
        94. Act.text.integrityCheckAlgorithm
        Definition

        Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

        Control0..1
        BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelIntegrity Check Algorithm
        96. Act.text.language
        Definition

        For character based information the language property specifies the human language of the text.

        Control0..1
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelLanguage
        98. Act.text.mediaType
        Definition

        Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

        Control0..1
        BindingFor example codes, see MediaType (3.0.0)
        (example to http://terminology.hl7.org/ValueSet/v3-MediaType|3.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelMedia Type
        100. Act.text.representation
        Control0..1
        BindingThe codes SHALL be taken from BinaryDataEncoding (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        102. Act.text.xmlText
        Definition

        Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

        ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
        Comments

        This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as unadorned text.
        104. Act.text.reference
        Definition

        A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
        LabelReference
        Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
        106. Act.text.thumbnail
        Definition

        An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        LabelThumbnail
        InvariantsED-1: Thumbnails cannot contain their own thumbnails (thumbnail.empty())
        108. Act.statusCode
        Comments

        SHALL contain exactly one [1..1] statusCode (CONF:1098-31498).

        Control1..1
        BindingThe codes SHALL be taken from ActStatus (3.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-ActStatus|3.0.0)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        110. Act.statusCode.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        112. Act.statusCode.code
        Definition

        The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

        ShortMAY be set to "completed"
        Comments

        This statusCode MAY contain zero or one [0..1] @code="completed" (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14) (CONF:1098-31499).

        Control0..1
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode
        114. Act.statusCode.codeSystem
        Definition

        Specifies the code system that defines the code.

        Control0..0
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System
        116. Act.statusCode.codeSystemName
        Definition

        The common name of the coding system.

        Control0..0
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System Name
        118. Act.statusCode.codeSystemVersion
        Definition

        If applicable, a version descriptor defined specifically for the given code system.

        Control0..0
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelCode System Version
        120. Act.statusCode.displayName
        Definition

        A name or title for the code, under which the sending system shows the code value to its users.

        Control0..0
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplay Name
        122. Act.statusCode.sdtcValueSet
        Definition

        The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

        Control0..1
        Typestring(oid: ISO Object Identifier)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
        124. Act.statusCode.sdtcValueSetVersion
        Definition

        The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
        126. Act.statusCode.originalText
        Definition

        The text or phrase used as the basis for the coding.

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
        LabelOriginal Text
        128. Act.statusCode.qualifier
        Definition

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

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
        LabelQualifier
        130. Act.statusCode.translation
        Definition

        A set of other concept descriptors that translate this concept descriptor into other code systems.

        Control0..0
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
        XML FormatThe type of this property is determined using the xsi:typeattribute.
        LabelTranslation
        132. Act.effectiveTime
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
        134. Act.priorityCode
        Control0..1
        BindingFor example codes, see ActPriority (3.0.0)
        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
        136. Act.languageCode
        Control0..1
        BindingThe codes SHALL be taken from AllLanguages
        (required to http://hl7.org/fhir/ValueSet/all-languages)
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        138. Act.subject
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
        140. Act.specimen
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
        142. Act.performer
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
        144. Act.author
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
        146. Act.informant
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
        148. Act.participant
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
        150. Act.entryRelationship
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
        152. Act.reference
        Comments

        MUST contain exactly one [1..1] reference.

        Control1..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
        154. Act.reference.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        156. Act.reference.realmCode
        Definition

        When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        158. Act.reference.typeId
        Definition

        When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
        160. Act.reference.typeId.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor (2.0.3-sd)
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor|2.0.3-sd)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        162. Act.reference.typeId.assigningAuthorityName
        Definition

        A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        164. Act.reference.typeId.displayable
        Definition

        Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        166. Act.reference.typeId.root
        Definition

        Identifies the type as an HL7 Registered model

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Fixed Value2.16.840.1.113883.1.3
        168. Act.reference.typeId.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        170. Act.reference.templateId
        Definition

        When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        172. Act.reference.typeCode
        Comments

        MUST contain exactly one [1..1] @typeCode="REFR" Reference (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-9026).

        Control1..1
        BindingThe codes SHALL be taken from XActRelationshipExternalReference (3.0.0)
        (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference|3.0.0)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueREFR
        174. Act.reference.seperatableInd
        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
        176. Act.reference.externalAct
        Comments

        Use externalAct to reference any other FHIR Entry Resource.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
        178. Act.reference.externalObservation
        Comments

        Use externalObservation to reference any FHIR Entry Observation Resource.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
        180. Act.reference.externalProcedure
        Comments

        Use externalProcedure to reference any FHIR Entry Procedure Resource.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
        182. Act.reference.externalDocument
        Comments

        Use externalDocument to reference any FHIR DocumentReference EntryResource or Composition Entry Resource.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
        184. Act.precondition
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
        186. Act.sdtcPrecondition2
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
        188. Act.sdtcInFulfillmentOf1
        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.