Id2.16.840.1.113883.3.1937.99.61.53.10.64Gültigkeit ab2019‑09‑10 11:38:11
Statusdraft EntwurfVersions-Label
NamePolicyActivityBezeichnungx_Policy Activity
Beschreibung
KontextElternknoten des Template-Element mit Id 2.16.840.1.113883.3.1937.99.61.53.10.64
KlassifikationTemplate-Typ nicht spezifiziert
Offen/GeschlossenOffen (auch andere als die definierten Elemente sind erlaubt)
Benutzt von / Benutzt
Benutzt von 0 Transactions und 1 Template, Benutzt 1 Template
Benutzt von als NameVersion
2.16.840.1.113883.3.1937.99.61.53.10.63Containmentdraft x_Coverage Activity2019‑09‑10 11:35:01
Benutzt als NameVersion
2.16.840.1.113883.10.20.22.5.2Inklusiondraft US Realm Address (AD.US.FIELDED) (2.1)2015‑08‑13
BeziehungSpezialisierung: Template 2.16.840.1.113883.10.20.22.4.61 Policy Activity (V3) (2015‑08‑01)
ref
ccda-

Spezialisierung: Template 2.16.840.1.113883.10.12.301 CDA Act (2005‑09‑07)
ref
ad1bbr-
ItemDTKardKonfBeschreibungLabel
cda:act
Polidotsvity
@classCode
cs1 … 1FACTCONFdots8898
 en-US SHALL contain exactly one [1..1] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-8898).
@moodCode
cs1 … 1FEVNCONFdots8899
 en-US SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-8899).
hl7:templateId
II1 … 1MPolidotsvity
@root
uid1 … 1F2.16.840.1.113883.3.1937.99.61.53.10.64
cda:templateId
II1 … 1Men-US SHALL contain exactly one [1..1] templateId (CONF:1198-8900) such that itCONFdots8900
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.61CONFdots0516
 en-US SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.61" (CONF:1198-10516).
@extension
st1 … 1F2015-08-01CONFdots2595
 en-US SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32595).
cda:id
II1 … *en-US SHALL contain at least one [1..*] id (CONF:1198-8901).

This id is a unique identifier for the policy or program providing the coverage

CONFdots8901
cda:code
CD1 … 1en-US SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Health Insurance Type urn:oid:2.16.840.1.113883.3.88.12.3221.5.2 DYNAMIC (CONF:1198-8903).CONFdots8903
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.3221.5.2 Health Insurance Type (DYNAMIC)
cda:translation
1 … *Men-US This code SHALL contain at least one [1..*] translation, which SHOULD be selected from ValueSet Payer urn:oid:2.16.840.1.114222.4.11.3591 (CONF:1198-32852).CONFdots2852
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.114222.4.11.3591 Payer (DYNAMIC)
cda:statusCode
CS1 … 1Men-US SHALL contain exactly one [1..1] statusCode (CONF:1198-8902).CONFdots8902
@code
CONF1 … 1Fcompleted
cda:performer
1 … 1Men-US SHALL contain exactly one [1..1] performer (CONF:1198-8906) such that it

This performer represents the Payer.

CONFdots8906
wo [cda:templateId/@root='2.16.840.1.113883.10.20.22.4.87']
@typeCode
cs1 … 1FPRFCONFdots8907
 en-US SHALL contain exactly one [1..1] @typeCode="PRF" Performer (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8907).
cda:templateId
II1 … 1Men-US SHALL contain exactly one [1..1] templateId (CONF:1198-16808).CONFdots6808
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.87CONFdots6809
 en-US This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.87" Payer Performer (CONF:1198-16809).
cda:assignedEntity
1 … 1MCONFdots8908
cda:id
II1 … *en-US This assignedEntity SHALL contain at least one [1..*] id (CONF:1198-8909).CONFdots8909
cda:code
CE0 … 1RCONFdots8914
cda:addr
AD0 … 1Ren-US This assignedEntity MAY contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8910).CONFdots8910
Eingefügt von 2.16.840.1.113883.10.20.22.5.2 US Realm Address (AD.US.FIELDED) (2015‑08‑13)
cda:addr
USRedotsLDED
@nullFlavor
cs0 … 1 
@use
set_cs0 … 1 en-US SHOULD contain zero or one [0..1] @use, which SHALL be selected from ValueSet PostalAddressUse urn:oid:2.16.840.1.113883.1.11.10637 STATIC 2005-05-01 (CONF:81-7290).CONFdots7290
 CONF
Der Wert von @use muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.10637 PostalAddressUse (DYNAMIC)
 Constrainten-US *SHALL NOT* have mixed content except for white space
cda:country
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] country, which SHALL be selected from ValueSet Country urn:oid:2.16.840.1.113883.3.88.12.80.63 DYNAMIC (CONF:81-7295).CONFdots7295
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.63 Country (DYNAMIC)
cda:state
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] state (ValueSet: StateValueSet urn:oid:2.16.840.1.113883.3.88.12.80.1 DYNAMIC) (CONF:81-7293).CONFdots7293
 Constrainten-US State is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.1 StateValueSet (DYNAMIC)
 Schematron assertrolered error 
 test@nullFlavor or (cda:country='US' and cda:state) or (cda:country!='US') or (not(cda:country) and cda:state) 
 MeldungState is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies. 
cda:city
ADXP1 … 1Ren-US SHALL contain exactly one [1..1] city (CONF:81-7292).CONFdots7292
cda:postalCode
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] postalCode, which SHOULD be selected from ValueSet PostalCode urn:oid:2.16.840.1.113883.3.88.12.80.2 DYNAMIC (CONF:81-7294). 
CONFdots7294
 Constrainten-US If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.2 PostalCode (DYNAMIC)
 Schematron assertrolered error 
 test@nullFlavor or (cda:country='US' and cda:postalCode) or (cda:country!='US') or (not(cda:country) and cda:postalCode) 
 MeldungIf the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). 
cda:streetAddressLine
ADXP1 … 4RCONFdots7291
 Schematron assertrolered error 
 test@nullFlavor or (count(cda:streetAddressLine) > 0 and count(cda:streetAddressLine) < 5) 
 MeldungSHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291) 
 Schematron assertrolered error 
 test@nullFlavor or (cda:city and cda:streetAddressLine)  
 Meldung 
cda:telecom
TEL0 … *en-US This assignedEntity MAY contain zero or more [0..*] telecom (CONF:1198-8911).CONFdots8911
cda:representedOrganization
0 … 1RCONFdots8912
 Schematron assertrolered error 
 testcda:performer[cda:templateId[@root='2.16.840.1.113883.10.20.22.4.87']]/cda:assignedEntity[count(cda:representedOrganization) < 2] 
 MeldungThis assignedEntity SHOULD contain zero or one [0..1] representedOrganization (CONF:1198-8912). 
cda:name
0 … 1Ren-US The representedOrganization, if present, SHOULD contain zero or one [0..1] name (CONF:1198-8913).CONFdots8913
cda:performer
0 … 1Ren-US SHOULD contain zero or one [0..1] performer="PRF" Performer (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8961) such that it

This performer represents the Guarantor.

CONFdots8961
wo [cda:templateId/@root='2.16.840.1.113883.10.20.22.4.88']
@typeCode
cs0 … 1FPRFCONFdots8961
cda:templateId
II1 … 1Men-US SHALL contain exactly one [1..1] templateId (CONF:1198-16810).CONFdots6810
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.88CONFdots6811
 en-US This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.88" Guarantor Performer (CONF:1198-16811).
cda:time
0 … 1Ren-US SHOULD contain zero or one [0..1] time (CONF:1198-8963).CONFdots8963
cda:assignedEntity
1 … 1MCONFdots8962
cda:code
CE1 … 1Men-US This assignedEntity SHALL contain exactly one [1..1] code (CONF:1198-8968).CONFdots8968
@code
CONF1 … 1FGUAR
@codeSystem
1 … 1F2.16.840.1.113883.5.110
cda:addr
AD0 … 1Ren-US This assignedEntity SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8964).CONFdots8964
Eingefügt von 2.16.840.1.113883.10.20.22.5.2 US Realm Address (AD.US.FIELDED) (2015‑08‑13)
cda:addr
USRedotsLDED
@nullFlavor
cs0 … 1 
@use
set_cs0 … 1 en-US SHOULD contain zero or one [0..1] @use, which SHALL be selected from ValueSet PostalAddressUse urn:oid:2.16.840.1.113883.1.11.10637 STATIC 2005-05-01 (CONF:81-7290).CONFdots7290
 CONF
Der Wert von @use muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.10637 PostalAddressUse (DYNAMIC)
 Constrainten-US *SHALL NOT* have mixed content except for white space
cda:country
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] country, which SHALL be selected from ValueSet Country urn:oid:2.16.840.1.113883.3.88.12.80.63 DYNAMIC (CONF:81-7295).CONFdots7295
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.63 Country (DYNAMIC)
cda:state
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] state (ValueSet: StateValueSet urn:oid:2.16.840.1.113883.3.88.12.80.1 DYNAMIC) (CONF:81-7293).CONFdots7293
 Constrainten-US State is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.1 StateValueSet (DYNAMIC)
 Schematron assertrolered error 
 test@nullFlavor or (cda:country='US' and cda:state) or (cda:country!='US') or (not(cda:country) and cda:state) 
 MeldungState is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies. 
cda:city
ADXP1 … 1Ren-US SHALL contain exactly one [1..1] city (CONF:81-7292).CONFdots7292
cda:postalCode
ADXP0 … 1Ren-US SHOULD contain zero or one [0..1] postalCode, which SHOULD be selected from ValueSet PostalCode urn:oid:2.16.840.1.113883.3.88.12.80.2 DYNAMIC (CONF:81-7294). 
CONFdots7294
 Constrainten-US If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.2 PostalCode (DYNAMIC)
 Schematron assertrolered error 
 test@nullFlavor or (cda:country='US' and cda:postalCode) or (cda:country!='US') or (not(cda:country) and cda:postalCode) 
 MeldungIf the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). 
cda:streetAddressLine
ADXP1 … 4RCONFdots7291
 Schematron assertrolered error 
 test@nullFlavor or (count(cda:streetAddressLine) > 0 and count(cda:streetAddressLine) < 5) 
 MeldungSHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291) 
 Schematron assertrolered error 
 test@nullFlavor or (cda:city and cda:streetAddressLine)  
 Meldung 
cda:telecom
TEL0 … *Ren-US This assignedEntity SHOULD contain zero or more [0..*] telecom (CONF:1198-8965).CONFdots8965
 Schematron assertrolered error 
 testcda:assignedPerson/cda:name | cda:representedOrganization/cda:name 
 Meldung*SHOULD* include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name 
cda:participant
1 … 1Men-US SHALL contain exactly one [1..1] participant (CONF:1198-8916) such that itCONFdots8916
wo [@typeCode='COV']
@typeCode
cs1 … 1FCOVCONFdots8917
 en-US SHALL contain exactly one [1..1] @typeCode="COV" Coverage target (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8917).
cda:templateId
II1 … 1Men-US SHALL contain exactly one [1..1] templateId (CONF:1198-16812).CONFdots6812
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.89CONFdots6814
 en-US This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.89" Covered Party Participant (CONF:1198-16814).
cda:time
0 … 1Ren-US SHOULD contain zero or one [0..1] time (CONF:1198-8918).CONFdots8918
cda:low
0 … 1Ren-US The time, if present, SHOULD contain zero or one [0..1] low (CONF:1198-8919).CONFdots8919
cda:high
0 … 1Ren-US The time, if present, SHOULD contain zero or one [0..1] high (CONF:1198-8920).CONFdots8920
cda:participantRole
1 … 1Men-US SHALL contain exactly one [1..1] participantRole (CONF:1198-8921).CONFdots8921
cda:id
II1 … *en-US This participantRole SHALL contain at least one [1..*] id (CONF:1198-8922).CONFdots8922
 Constrainten-US This id is a unique identifier for the covered party member. Implementers *SHOULD* use the same GUID for each instance of a member identifier from the same health plan
cda:code
CD1 … 1en-US This participantRole SHALL contain exactly one [1..1] code (CONF:1198-8923).CONFdots8923
cda:addr
AD0 … 1Ren-US This participantRole SHOULD contain zero or one [0..1] addr (CONF:1198-8956).CONFdots8956
 Schematron assertrolered error 
 testcda:addr[cda:streetAddressLine and cda:city and (cda:country!='US' or ((not(cda:country) or cda:country!='US') and cda:state and cda:postalCode))] 
 MeldungThe content of addr *SHALL* be a conformant US Realm Address (AD.US.FIELDED) (2.16.840.1.113883.10.20.22.5.2) 
cda:playingEntity
0 … 1RCONFdots8932
cda:name
1 … *Ren-US The playingEntity, if present, SHALL contain at least one [1..*] name (CONF:1198-8930).

If the covered party’s name is recorded differently in the health plan and in the registration/pharmacy benefit summary (due to marriage or for other reasons), use the name as it is recorded in the health plan.

CONFdots8930
sdtc:birthTime
TS1 … 1Ren-US The playingEntity, if present, SHALL contain exactly one [1..1] sdtc:birthTime (CONF:1198-31344).

If the covered party’s date of birth is recorded differently in the health plan and in the registration/pharmacy benefit summary, use the date of birth as it is recorded in the health plan.

CONFdots1344
 Constrainten-US The prefix sdtc: *SHALL* be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element.
cda:participant
0 … 1Ren-US SHOULD contain zero or one [0..1] participant (CONF:1198-8934) such that it

When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.

CONFdots8934
wo [@typeCode='HLD']
@typeCode
cs1 … 1FHLDCONFdots8935
 en-US SHALL contain exactly one [1..1] @typeCode="HLD" Holder (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8935).
 Constrainten-US When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information
cda:templateId
II1 … 1Men-US SHALL contain exactly one [1..1] templateId (CONF:1198-16813).CONFdots6813
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.90CONFdots6815
 en-US This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.90" Policy Holder Participant (CONF:1198-16815).
cda:time
0 … 1en-US MAY contain zero or one [0..1] time (CONF:1198-8938).CONFdots8938
cda:participantRole
1 … 1Men-US SHALL contain exactly one [1..1] participantRole (CONF:1198-8936).CONFdots8936
cda:id
II1 … *en-US This participantRole SHALL contain at least one [1..*] id (CONF:1198-8937).CONFdots8937
 Constrainten-US This id is a unique identifier for the subscriber of the coverage
cda:addr
AD0 … 1Ren-US This participantRole SHOULD contain zero or one [0..1] addr (CONF:1198-8925).CONFdots8925
 Schematron assertrolered error 
 testcda:addr[cda:streetAddressLine and cda:city and ((not(cda:country) or cda:country!='US') or (cda:country='US' and cda:state and cda:postalCode))] 
 MeldungThe content of addr *SHALL* be a conformant US Realm Address (AD.US.FIELDED) (2.16.840.1.113883.10.20.22.5.2) 
cda:entryRelationship
1 … *Men-US SHALL contain at least one [1..*] entryRelationship (CONF:1198-8939) such that itCONFdots8939
@typeCode
cs1 … 1FREFRCONFdots8940
 en-US SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8940).
 Constrainten-US The target of a policy activity with act/entryRelationship/@typeCode="REFR" *SHALL* be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[@moodCode="DEF"], representing a description of the coverage plan.
A description of the coverage plan *SHALL* contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan.