Id2.16.840.1.113883.10.20.22.4.140Effective Date2015‑08‑13
Statusdraft DraftVersion Label2.1
NamePatientReferralActDisplay NamePatient Referral Act
Description
This template represents the type of referral (e.g., for dental care, to a specialist, for aging problems) and represents whether the referral is for full care or shared care. It may contain a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
ContextParent nodes of template element with id 2.16.840.1.113883.10.20.22.4.140
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 2 transactions and 3 templates, Uses 2 templates
Used by as NameVersion
2.16.840.1.113883.3.1937.99.3.4.31Transactionfinal Transfer Summary (V2)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.30Transactionfinal Referral Note (V2)2015‑08‑01
1.3.6.1.4.1.19376.1.5.3.1.3.1Containmentdraft Reason for Referral Section (V2) (2.1)2014‑06‑09
2.16.840.1.113883.10.20.22.1.13linkdraft Transfer Summary (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.14linkdraft Referral Note (V2) (2.1)2015‑08‑01
Uses as NameVersion
2.16.840.1.113883.10.20.22.4.19Containmentdraft Indication (V2) (2.1)2014‑06‑09
2.16.840.1.113883.10.20.22.4.119Containmentdraft Author Participation (2.1)2015‑08‑13
RelationshipSpecialization: template 2.16.840.1.113883.10.12.301 CDA Act (2005‑09‑07)
ref
ad1bbr-
ItemDTCardConfDescriptionLabel
cda:act
PatidotslAct
@classCode
cs1 … 1FPCPRCONFdots0884
 SHALL contain exactly one [1..1] @classCode="PCPR" provision of care (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-30884).
@moodCode
cs1 … 1RSHALL contain exactly one [1..1] @moodCode, which SHALL be selected from ValueSet Patient Referral Act moodCode urn:oid:2.16.840.1.113883.11.20.9.66 STATIC 2014-09-01 (CONF:1098-30885).CONFdots0885
 CONF
The value of @moodCode shall be drawn from value set 2.16.840.1.113883.11.20.9.66 Patient Referral Act moodCode (DYNAMIC)
cda:templateId
II1 … 1MSHALL contain exactly one [1..1] templateId (CONF:1098-30886) such that itCONFdots0886
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.140CONFdots0887
 SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.140" (CONF:1098-30887).
cda:id
II1 … *SHALL contain at least one [1..*] id (CONF:1098-30888).

In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.		CONFdots0888
cda:code
CD1 … 1SHALL contain exactly one [1..1] code, which SHALL be selected from ValueSet Referral Types urn:oid:2.16.840.1.113883.11.20.9.56 DYNAMIC (CONF:1098-30889).CONFdots0889
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.11.20.9.56 Referral Types (DYNAMIC)
cda:statusCode
CS1 … 1MSHALL contain exactly one [1..1] statusCode (CONF:1098-30892).CONFdots0892
@code
CONF1 … 1Factive
cda:effectiveTime
1 … 1SHALL contain exactly one [1..1] effectiveTime (CONF:1098-30893).

The effectiveTime represents the time when the future referral is intended to take place.		CONFdots0893
cda:priorityCode
0 … 1RSHOULD contain zero or one [0..1] priorityCode (CONF:1098-32623).

CONFdots2623
cda:author
0 … *RSHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1098-31612).
Contains 2.16.840.1.113883.10.20.22.4.119 Author Participation (2015‑08‑13)		CONFdots1612
cda:participant
0 … *MAY contain zero or more [0..*] participant (CONF:1098-32635).CONFdots2635
@typeCode
cs1 … 1FREFTCONFdots2638
 The participant, if present, SHALL contain exactly one [1..1] @typeCode="REFT" Referred to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-32638).
cda:participantRole
1 … 1MThe participant, if present, SHALL contain exactly one [1..1] participantRole (CONF:1098-32636).CONFdots2636
cda:code
CD0 … 1This participantRole MAY contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy (HIPAA) urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1098-32637).CONFdots2637
 CONF
The value of @code shall be drawn from value set 2.16.840.1.114222.4.11.1066 Healthcare Provider Taxonomy (DYNAMIC)
cda:entryRelationship
0 … *MAY contain zero or more [0..*] entryRelationship (CONF:1098-31604) such that it

The following entryRelationship represents whether the referral is for full or shared care.		CONFdots1604
@typeCode
cs1 … 1FSUBJCONFdots1613
 SHALL contain exactly one [1..1] @typeCode="SUBJ" has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31613).
cda:observation
1 … 1MSHALL contain exactly one [1..1] observation (CONF:1098-31605).CONFdots1605
@classCode
cs1 … 1FOBSCONFdots1606
 This observation SHALL contain exactly one [1..1] @classCode="OBS" observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31606).
@moodCode
cs1 … 1FRQOCONFdots1607
 This observation SHALL contain exactly one [1..1] @moodCode="RQO" request (CodeSystem: ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31607).
cda:code
CD1 … 1MThis observation SHALL contain exactly one [1..1] code (CONF:1098-31608).CONFdots1608
@code
CONF1 … 1FASSERTION
@codeSystem
1 … 1F2.16.840.1.113883.5.4
cda:statusCode
CS1 … 1MThis observation SHALL contain exactly one [1..1] statusCode (CONF:1098-31614).CONFdots1614
@code
CONF1 … 1Fcompleted
cda:priorityCode
0 … 1RThis observation SHOULD contain zero or one [0..1] priorityCode, which SHOULD be selected from ValueSet Act Priority urn:oid:2.16.840.1.113883.1.11.16866 DYNAMIC (CONF:1098-32443).

CONFdots2443
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.16866 ActPriority (DYNAMIC)
cda:value
CD1 … 1MThis observation SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Care Model urn:oid:2.16.840.1.113883.11.20.9.61 DYNMAIC (CONF:1098-31611).CONFdots1611
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.11.20.9.61 Care Model (DYNAMIC)
cda:entryRelationship
0 … *The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Contains 2.16.840.1.113883.10.20.22.4.19 Indication (V2) (2014‑06‑09)		CONFdots1635
@typeCode
cs1 … 1FRSONCONFdots1636
 SHALL contain exactly one [1..1] @typeCode="RSON" has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31636).