Item | DT | Card | Conf | Description | Label |
---|
cda:act
| | | | | Notevity |
@nullFlavor
| cs | 0 … 1 | | MAY contain zero or one [0..1] @nullFlavor (CONF:X-X). |
@classCode
| cs | 1 … 1 | R | SHALL contain exactly one [1..1] @classCode (CONF:X-X). |
@moodCode
| cs | 1 … 1 | R | SHALL contain exactly one [1..1] @moodCode (CONF:X-X). |
@negationInd
| bl | 0 … 1 | | MAY contain zero or one [0..1] @negationInd (CONF:X-X). |
cda:realmCode
| | 0 … * | | MAY contain zero or more [0..*] realmCode (CONF:X-X). | Notevity |
cda:typeId
| | 0 … 1 | | MAY contain zero or one [0..1] typeId (CONF:X-X). | Notevity |
cda:templateId
| | 1 … 1 | M | SHALL contain exactly one [1..1] templateId (CONF:3250-16933) such that it | CONF6933 |
@root
| uid | 1 … 1 | F | 2.16.840.1.113883.10.20.22.4.202 | CONF6934 |
| SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.202" (CONF:3250-16934). |
@extension
| st | 1 … 1 | F | 2016-11-01 | CONF6937 |
| SHALL contain exactly one [1..1] @extension="2016-11-01" (CONF:3250-16937). |
cda:id
| | 0 … * | | MAY contain zero or more [0..*] id (CONF:X-X). | Notevity |
cda:code
| | 1 … 1 | M | SHALL contain exactly one [1..1] code (CONF:3250-16895). | CONF6895 |
@code
| CONF | 1 … 1 | F | 34109-9 |
@codeSystem
| 1 … 1 | F | 2.16.840.1.113883.6.1 |
cda:translation
| | 0 … * | R | This code SHOULD contain zero or more [0..*] translation, which SHALL be selected from ValueSet Note Types urn:oid:2.16.840.1.113883.11.20.9.68 DYNAMIC (CONF:3250-16939) such that itWhen the Note Activity is within a Note Section, the code SHOULD match or specialize the section code.If the Note Activity is within a typically narrative-only section, the code MAY match the section code. | CONF6939 |
cda:text
| | 1 … 1 | M | SHALL contain exactly one [1..1] text (CONF:3250-16896). | CONF6896 |
@mediaType
| st | 0 … 1 | | This text MAY contain zero or one [0..1] @mediaType, which SHOULD be selected from ValueSet SupportedFileFormats urn:oid:2.16.840.1.113883.11.20.7.1 DYNAMIC (CONF:3250-16906).If the note was originally in another format, such as RTF, this element may also contain the base-64-encoded raw data of the note in addition to a reference to the narrative. | CONF6906 |
cda:reference
| | 1 … 1 | M | This text SHALL contain exactly one [1..1] reference (CONF:3250-16897). | CONF6897 |
@nullFlavor
| cs | 1 … 1 | R | This reference SHALL NOT contain [0..0] @nullFlavor (CONF:3250-16920).The note activity must reference human-readable content in the narrative, so this reference must not be null. | CONF6920 |
@value
| | 1 … 1 | R | This reference SHALL contain exactly one [1..1] @value (CONF:3250-16898). | CONF6898 |
cda:statusCode
| | 1 … 1 | M | SHALL contain exactly one [1..1] statusCode (CONF:3250-16916).Indicates the status of the note. The most common statusCode is completed indicating the note is signed and finalized. | CONF6916 |
cda:effectiveTime
| | 1 … 1 | M | SHALL contain exactly one [1..1] effectiveTime (CONF:3250-16903).The effectiveTime represents the clinically relevant time of the note. The precise timestamp of creation / updating should be conveyed in author/time. | CONF6903 |
@value
| | 0 … 1 | | This effectiveTime SHOULD contain zero or one [0..1] @value (CONF:3250-16917). | CONF6917 |
cda:priorityCode
| | 0 … 1 | | MAY contain zero or one [0..1] priorityCode (CONF:X-X). | Notevity |
cda:languageCode
| | 0 … 1 | | MAY contain zero or one [0..1] languageCode (CONF:X-X). | Notevity |
cda:subject
| | 0 … 1 | | MAY contain zero or one [0..1] subject (CONF:X-X). | Notevity |
cda:specimen
| | 0 … * | | MAY contain zero or more [0..*] specimen (CONF:X-X). | Notevity |
cda:performer
| | 0 … * | | MAY contain zero or more [0..*] performer (CONF:X-X). | Notevity |
cda:author
| | 1 … * | M | SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:3250-16913).Represents the person(s) who wrote the note. | CONF6913 |
cda:informant
| | 0 … * | | MAY contain zero or more [0..*] informant (CONF:X-X). | Notevity |
cda:participant
| | 0 … * | | MAY contain zero or more [0..*] participant (CONF:3250-16923) such that itRepresents the person(s) legally responsible for the contents of the note. | CONF6923 |
@typeCode
| cs | 1 … 1 | F | LA | CONF6925 |
| SHALL contain exactly one [1..1] @typeCode="LA" Legal Authenticator (CONF:3250-16925). |
cda:time
| | 1 … 1 | M | SHALL contain exactly one [1..1] US Realm Date and Time (DT.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.3) (CONF:3250-16926).Indicates the time of signing the note. | CONF6926 |
cda:participantRole
| | 1 … 1 | M | SHALL contain exactly one [1..1] participantRole (CONF:3250-16924).If no id matches an author or participant elsewhere in the document, then playingEntity SHALL be present. | CONF6924 |
cda:id
| | 1 … * | M | This participantRole SHALL contain at least one [1..*] id (CONF:3250-16927).This may be the ID of the note author. If so, no additional information in this participant is required. | CONF6927 |
cda:playingEntity
| | 0 … 1 | | This participantRole MAY contain zero or one [0..1] playingEntity (CONF:3250-16928). | CONF6928 |
cda:name
| | 1 … * | M | The playingEntity, if present, SHALL contain at least one [1..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:3250-16929). | CONF6929 |
cda:entryRelationship
| | 0 … * | R | Links the note to an encounter. If the Note Activity is present within a document containing an encompassingEncounter, then this entryRelationship is optional and the note is associated with the encounter represented by the encompassingEncounter. | CONF6907 |
@typeCode
| cs | 1 … 1 | F | COMP | CONF6921 |
| SHALL contain exactly one [1..1] @typeCode="COMP" (CONF:3250-16921). |
@inversionInd
| bl | 1 … 1 | F | true | CONF6922 |
| SHALL contain exactly one [1..1] @inversionInd="true" (CONF:3250-16922). |
@negationInd
| bl | 0 … 1 | | MAY contain zero or one [0..1] @negationInd (CONF:3250-16931).To communicate that the note is not associated with any encounter, this entryRelationship MAY be included with @negationInd=true and encounter/id/@nullFlavor=NA. The negationInd + encounter indicate this note is not associated with any encounter. | CONF6931 |
| Constraint | SHOULD contain zero or more [0..*] entryRelationship (CONF:3250-16907) such that it |
cda:encounter
| | 1 … 1 | M | SHALL contain exactly one [1..1] encounter (CONF:3250-16908). | CONF6908 |
cda:id
| | 1 … * | M | This encounter SHALL contain at least one [1..*] id (CONF:3250-16909).If the id does not match an encounter/id from the Encounters Section within the same document and the id does not contain @nullFlavor=NA, then this entry SHALL conform to the Encounter Activity (V3) (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01). | CONF6909 |
cda:reference
| | 0 … * | | MAY contain zero or more [0..*] reference (CONF:3250-16910) such that itRepresents an unstructured C-CDA document containing the original contents of the note in the original format. | CONF6910 |
cda:externalDocument
| | 1 … 1 | M | SHALL contain exactly one [1..1] externalDocument (CONF:3250-16911). | CONF6911 |
cda:id
| | 1 … 1 | M | This externalDocument SHALL contain exactly one [1..1] id (CONF:3250-16915). | CONF6915 |
cda:code
| | 0 … 1 | R | This externalDocument SHOULD contain zero or one [0..1] code (CONF:3250-16918). | CONF6918 |
cda:precondition
| | 0 … * | | MAY contain zero or more [0..*] precondition (CONF:X-X). | Notevity |
sdtc:precondition2
| | 0 … * | | MAY contain zero or more [0..*] sdtc:precondition2 (CONF:X-X). | Notevity |
sdtc:inFulfillmentOf1
| | 0 … * | | MAY contain zero or more [0..*] sdtc:inFulfillmentOf1 (CONF:X-X). | Notevity |