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: Initial Treatment Order Entry

Official URL: http://hl7.org/cda/us/adi/StructureDefinition/InitialTreatmentOrderEntry | Version: 0.1.0
Active as of 2026-05-29 | Computable Name: Initial_Treatment_Order_Entry
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.9.275.3.2:2026-08-28

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:

- Use this Logical Model Profile: Planned Procedure PMO Section

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.

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

This structure is derived from Act

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: RQO
id |  | 1..* | II |
code |  |  |  |
@code |  | 0..1 | cs | Required Pattern: 100823-4
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS |
@code |  | 0..1 | cs | Required Pattern: active
effectiveTime |  | 1..1 | IVL_TS |
Slices for entryRelationship | S | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
entryRelationship:planned-procedure-part | S | 0..1 | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
procedure | S | 1..1 | Initial_Treatment_Planned_Procedure_Part |
entryRelationship:clinical-instruction-part | S | 0..* | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
observation | S | 1..1 | InstructionObservation |
entryRelationship:goal-part | S | 0..* | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | 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.
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode |  | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: RQO
@negationInd |  | 0..1 | bl |
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: ActCode (3.0.0) (example)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: 100823-4
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS | Binding: ActStatus (3.0.0) (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: active
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | 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 | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
encounter |  | 0..1 | Encounter |
observation |  | 0..1 | Observation |
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:planned-procedure-part | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Initial_Treatment_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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Act.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.templateId:initial-treatment-order.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-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 v7.0
Act.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.statusCode | Base | required | ActStatus | 📍3.0.0 | THO v7.0
Act.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.priorityCode | Base | example | ActPriority | 📍3.0.0 | THO v7.0
Act.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Act.entryRelationship:order-detail-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:planned-procedure-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:clinical-instruction-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:goal-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Act.typeId, Act.entryRelationship:order-detail-part.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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode |  | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: RQO
@negationInd |  | 0..1 | bl |
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: ActCode (3.0.0) (example)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: 100823-4
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS | Binding: ActStatus (3.0.0) (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: active
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | 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 | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
encounter |  | 0..1 | Encounter |
observation |  | 0..1 | Observation |
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:planned-procedure-part | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Initial_Treatment_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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Act.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.templateId:initial-treatment-order.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-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 v7.0
Act.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.statusCode | Base | required | ActStatus | 📍3.0.0 | THO v7.0
Act.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.priorityCode | Base | example | ActPriority | 📍3.0.0 | THO v7.0
Act.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Act.entryRelationship:order-detail-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:planned-procedure-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:clinical-instruction-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:goal-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Act.typeId, Act.entryRelationship:order-detail-part.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()`

This structure is derived from Act

Summary

Mandatory: 11 elements(3 nested mandatory elements)
Must-Support: 8 elements
Fixed: 10 elements

Structures

This structure refers to these other structures:

- Initial Treatment Order Detail (http://hl7.org/cda/us/adi/StructureDefinition/InitialTreatmentOrderDetailPart)
- Initial Treatment Procedure Information (http://hl7.org/cda/us/adi/StructureDefinition/InitialTreatmentPlannedProcedurePart)
- Instruction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/InstructionObservation)
- Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation)

Slices

This structure defines the following Slices:

- The element 2 is sliced based on the values of Act.templateId
- The element 3 is sliced based on the values of Act.entryRelationship

Differential View

This structure is derived from Act

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: RQO
id |  | 1..* | II |
code |  |  |  |
@code |  | 0..1 | cs | Required Pattern: 100823-4
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS |
@code |  | 0..1 | cs | Required Pattern: active
effectiveTime |  | 1..1 | IVL_TS |
Slices for entryRelationship | S | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
entryRelationship:planned-procedure-part | S | 0..1 | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
procedure | S | 1..1 | Initial_Treatment_Planned_Procedure_Part |
entryRelationship:clinical-instruction-part | S | 0..* | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
observation | S | 1..1 | InstructionObservation |
entryRelationship:goal-part | S | 0..* | EntryRelationship |
@typeCode |  | 1..1 | cs | Fixed Value: COMP
@inversionInd |  | 0..1 | bl | 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.
Documentation for this format

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode |  | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: RQO
@negationInd |  | 0..1 | bl |
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: ActCode (3.0.0) (example)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: 100823-4
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS | Binding: ActStatus (3.0.0) (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: active
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | 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 | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
encounter |  | 0..1 | Encounter |
observation |  | 0..1 | Observation |
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:planned-procedure-part | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Initial_Treatment_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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Act.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.templateId:initial-treatment-order.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-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 v7.0
Act.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.statusCode | Base | required | ActStatus | 📍3.0.0 | THO v7.0
Act.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.priorityCode | Base | example | ActPriority | 📍3.0.0 | THO v7.0
Act.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Act.entryRelationship:order-detail-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:planned-procedure-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:clinical-instruction-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:goal-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Act.typeId, Act.entryRelationship:order-detail-part.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()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Act |  | 1..1 | Act | 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)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:initial-treatment-order |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.9.275.3.2
@extension |  | 1..1 | st | Required Pattern: 2026-08-28
@classCode |  | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode |  | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: RQO
@negationInd |  | 0..1 | bl |
id |  | 1..* | II |
code |  | 1..1 | CD | Binding: ActCode (3.0.0) (example)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: 100823-4
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR |
translation |  | 0..* | CD |
text |  | 1..1 | ED | links to the rendering of the portable medical order
statusCode |  | 1..1 | CS | Binding: ActStatus (3.0.0) (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | Required Pattern: active
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | 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 | 1..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act, profile:procedure
entryRelationship:order-detail-part |  | 1..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | Initial_Treatment_Order_Detail_Part |
encounter |  | 0..1 | Encounter |
observation |  | 0..1 | Observation |
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:planned-procedure-part | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Initial_Treatment_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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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 | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: XActRelationshipEntryRelationship (3.0.0) (required) Fixed Value: COMP
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
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)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Act.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.templateId:initial-treatment-order.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-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 v7.0
Act.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.statusCode | Base | required | ActStatus | 📍3.0.0 | THO v7.0
Act.statusCode.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.priorityCode | Base | example | ActPriority | 📍3.0.0 | THO v7.0
Act.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Act.entryRelationship:order-detail-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:order-detail-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:planned-procedure-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:planned-procedure-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:clinical-instruction-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:clinical-instruction-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0
Act.entryRelationship:goal-part.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.2-sd | Clinical Document Architecture v2.0
Act.entryRelationship:goal-part.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Act.typeId, Act.entryRelationship:order-detail-part.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()`

This structure is derived from Act

Summary

Mandatory: 11 elements(3 nested mandatory elements)
Must-Support: 8 elements
Fixed: 10 elements

Structures

This structure refers to these other structures:

- Initial Treatment Order Detail (http://hl7.org/cda/us/adi/StructureDefinition/InitialTreatmentOrderDetailPart)
- Initial Treatment Procedure Information (http://hl7.org/cda/us/adi/StructureDefinition/InitialTreatmentPlannedProcedurePart)
- Instruction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/InstructionObservation)
- Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation)

Slices

This structure defines the following Slices:

- The element 2 is sliced based on the values of Act.templateId
- The element 3 is sliced based on the values of Act.entryRelationship

Other representations of profile: CSV, Excel