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To accurately process the Header and Problems sections of a C-CDA CCD, in the Clinical:GenericProblemCcda Data Space, certain elements are required and must contain valid information. There are also certain elements that are optional but, if present, must also contain valid information. 

In the Header section, there are eight elements that are required and three elements that are optional. For more information see CCDA Header: Data Preparation Checklist.

In the Problems section, there are six elements that are required and eleven elements that are optional

This checklist provides a description of the Problems elements and how they should be validated prior to processing in CDS.  

The problems section of a CCD will typically have several sub-sections to represent different aspects of a problem:

  • Problem Concern Act
  • Problem Observation
  • Age Observation
  • Priority Preference

Each sub-section is uniquely identified by its templateId. When elements occur in multiple sub-sections (for example, value, code, effectiveTime), the templateId helps define what validation is required.

 Section or Sub-SectionElementXPath
Required ElementsProblems SectiontemplateIdsection/templateId
codesection/code
Problem Concern ActtemplateIdsection/entry/act/templateId
codesection/entry/act/code
statusCodesection/entry/act/statusCode
effectiveTimesection/entry/act/effectiveTime
Optional (but validated
if present) Elements 
Problem Concern Act

author

section/entry/act/author
Problem ObservationtemplateIdsection/entry/act/entryRelationship/observation/templateId
codesection/entry/act/entryRelationship/observation/code
effectiveTimesection/entry/act/entryRelationship/observation/effectiveTime
timesection/entry/act/entryRelationship/observation/author/time
valuesection/entry/act/entryRelationship/observation/value
Age ObservationtemplateIdsection/entry/act/entryRelationship/observation/entryRelationship/observation/templateId
codesection/entry/act/entryRelationship/observation/entryRelationship/observation/code
valuesection/entry/act/entryRelationship/observation/entryRelationship/observation/value
Priority PreferencetemplateIdsection/entry/act/entryRelationship/observation/entryRelationship/observation/templateId
value section/entry/act/entryRelationship/observation/entryRelationship/observation/value

A full copy of the sample Continuity of Care Document (CCD) used in this section is attached.

 


 

Required Elements

This section details the elements that are required for processing in Clinical Data Spaces, that is, they must be present, contain certain information, and be correct.

Problems Section templateId

XPath:section/templateId
Purpose:Specifies which CCDA R2.1 template is being used to structure the problems section. R2.1 templates define the requirements, format, and structure of a CCD section. This section describes all relevant clinical problems - both current and historical. Overall health status may also be represented in this section.
The templateId element must:
  • be present
  • contain a root attribute

    AttributeValuePurpose
    rootMust have a value of 2.16.840.1.113883.10.20.22.2.5.1Uniquely identifies the problems section template
Code Example of Problems Section templateId
 <section> 
    <templateID root=”2.16.840.1.113883.10.20.22.2.5.1”/> 
</section>

The entire problems section is ignored if the templateId element is not provided with a root attribute of 2.16.840.1.113883.10.20.22.2.5.1. The information provided in this section will not be processed and you will not receive any notification that this section was ignored.

 

 

 

Problem Section code

XPath:section/code
Purpose:Identifies that this section is detailing problem information
The code element must:
  • be present

  • contain code and codeSystem attributes

    AttributeValuePurpose

    code

    Must have a value of 11450-4

    Identifies that this section is detailing problem information

    codeSystem

    Must have a value of 2.16.840.1.1113883.6.1

    Identifies the LOINC coding system used to translate the identifier provided in the code attribute

    displayName and codeSystemName are not required for processing.

Code Example of Problem Section code
<section> 
    <templateID root=”2.16.840.1.113883.10.20.22.2.5”/> 
    <code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem List"/>
</section>

Processing of the code element will fail if it does not contain correctly populated code AND codeSystem attributes.

 

Problem Concern Act templateId

XPath:section/entry/act/templateId
Purpose:Specifies which CCDA R2.1 template is being used to structure the problem concern act sub-section. R2.1 templates define the requirements, format, and structure of a CCD section. This sub-section describes an ongoing concern on behalf of the provider that added this concern to the patient's problem list.
The templateId element must:
  • be present
  • contain a root attribute

    AttributeValuePurpose
    rootMust have a value of 2.16.840.1.113883.10.20.22.4.3Uniquely identifies the problem concern act sub-section template
Code Example of Problem Act templateId
 <section> 
    <templateID root="2.16.840.1.113883.10.20.22.2.5"/> 
    <entry typeCode="DRIV">   
        <act classCode="ACT" moodCode="EVN">
            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
        </act>
    </entry>
</section>

The entire problem concern act sub-section is ignored if the templateId element is not provided with a root attribute of 2.16.840.1.113883.10.20.22.4.3. The information provided in this section will not be processed and you will not receive any notification that this section was ignored.

 

Problem Concern Act code

XPath:section/entry/act/code
Purpose:Provides information about the type of activity detailed in this sub-section
The code element must:
  • be present

  • contain code and codeSystem attributes

    AttributeValuePurpose

    code

    Must have a value of CONC

    Identifies that this section is detailing problem concern information.

    codeSystem

    Must have a value of 2.16.840.1.113883.5.6

    Identifies the HL7 Act Class coding system used to translate the identifier provided in the code attribute

    displayName and codeSystemName are not required for processing

Code example of Problem Act code
  <section> 
    <templateID root="2.16.840.1.113883.10.20.22.2.5"/> 
    <entry typeCode="DRIV">   
        <act classCode="ACT"moodCode="EVN">
            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
			<code code="CONC"codeSystem"2.16.840.1.113883.5.6"/>
        </act>
    </entry>
</section>

Processing of the code element will fail if it does not contain correctly populated code AND codeSystem attributes.

 

 

Problem Concern Act statusCode

XPath:section/entry/act/statusCode
Purpose:Indicates the current status of the concern.
The statusCode element must:
  • be present
  • contain a code attribute

    AttributeValuePurpose
    codeMust have one of the following:
    • completed
    • aborted
    • active
    • suspended

    Indicates the current status of the concern. Of note:

    • Active indicates that the underlying condition is still of concern and interest to the provider (whether active or resolved)
    • Completed indicates that the underlying condition is no longer of a concern or interest to the provider.
Code Example of Problem Act statusCode
 <section> 
    <templateID root="2.16.840.1.113883.10.20.22.2.5"/> 
    <entry typeCode="DRIV">   
        <act classCode="ACT"moodCode="EVN">
            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
			<statusCode code="completed"/>
        </act>
    </entry>
</section>

Processing of the statusCode element will fail if it does not contain a correctly populated code attribute.

 

 

Problem Concern Act effectiveTime

XPath:section/entry/act/effectiveTime
Purpose:Indicates the time that the underlying condition was felt to be a concern. It may or may not correspond to the actual time of the condition.
The effectiveTime element must:
  • be present
  • contain an attribute of xsi:type, value or nullFlavor

    AttributeValuePurpose
    xsi:type

    Must be populated with IVL_TS and effectiveTime must:

    1. have a low child element, which can be:
      • empty
      • have a nullFlavor attribute
      • have a value attribute indicating a specific date and time
    2. optionally have a high child element which can be:
      • empty
      • have a nullFlavor attribute
      • have a value attribute indicating a specific date and time
    Indicates the period over which the underlying condition was a concern. Low indicates the onset date (when the concern first became active) and high specifies when the concern was known to be resolved. If high is not present, the concern is ongoing.
    valueMust be populated with a date in the format YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-ZZZZ] where +/-ZZZZspecifies the offset from Coordinated Universal Time. Onset date. Specifies when the underlying condition first became a concern.
    nullFlavor

    Must be one of the following:

    • ASKU - asked but unknown
    • MSK - masked (for sensitivity or confidentiality reasons)
    • NA - not available, system down
    • NASK - not asked
    • NAV - not available
    • NI - no information
    • OTH - other
    • UNK - unknown 
    Indicates that an attribute was needed, but was not provided, and gives a reason for why the information is not present. In this case, it suggests that the concern is no longer ongoing.

     

Code Example of Problem Act effectiveTime
<section> 
    <templateID root="2.16.840.1.113883.10.20.22.2.5"/> 
    <entry typeCode="DRIV">   
        <act classCode="SBADM" moodCode="ACT" moodCode="EVN">
            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
			<effectiveTime>
					<low value="199803"/>
					<high value="20110103"/>
			</effectiveTime>
        </act>
    </entry>
</section>

Processing of the effectiveTime element will fail if it does not contain a correctly populated xsi:typevalue or nullFlavor attribute.

 

 

 


Optional Elements

This section details elements that are not required but if present, must contact certain information and be correct for accurate processing in Clinical Data Spaces (CDS). 

Problem Concern Act author

XPath:section/entry/act/entryRelationship/observation/author
Purpose:

Indicates the unique identifier of the person describing the ongoing concern.

If present, the templateId element must:
  • have a child element of assignedAuthor, which must
  • have a child element of id, which must
  • contain a root attribute and optionally contain an extension attribute

    tributeValuePurpose
    root

    Must include an alphanumeric string in an OID (object identifier) or UUID (universally unique identifier) format. 

    For example, OID: 2.16.840.1.1113883.x.xx.x  or  UUID: 53459040-b1b4-49ed-ae1f-a52c8c502df4

    Uniquely identifies the author of the problem concern act

    extension

    Is optional and can include an alphanumeric string of any length

    Uniquely identifies the author of the problem concern act

Code Example of Problem Concern Act author
<entry typeCode="DRIV">   
        <act classCode="ACT" moodCode="EVN">
            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
			<author>
            	<assignedAuthor>
                	<id extension="555555555" root="2.16.840.1.113883.4.6"/>
            	</assignedAuthor>
			</author>
        </act>
</entry>

The author element and its contents will be ignored if the id element does not contain a correctly populated root attribute. Information provided within the author element in the document header will be processed instead.

 

 

 

Problem Observation templateId

XPath:section/entry/act/entryRelationship/observation/templateId
Purpose:Specifies which CCDA R2.1 template is being used to structure the problem observation sub-section. R2.1 templates define the requirements, format, and structure of a CCD section. This sub-section represents a discrete observation about a patient's problem.
If present, the templateId element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ"
  • have a parent element of observation
  • contain a root attribute

    AttributeValuePurpose
    root2.16.840.1.113883.10.20.22.4.4Uniquely identifies the problem observation sub-section template
Code Example of Problem Observation templateId
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
			</observation>
		</entryRelationship>			
   </act>
</entry>

The entire problem observation sub-section is ignored if the templateId element is not provided with a root attribute of 2.16.840.1.113883.10.20.22.4.4.The information provided in this sub-section will not be processed and you will not receive any notification that this sub-section was ignored.

 

 

Problem Observation code

XPath:section/entry/act/entryRelationship/observation/code
Purpose:Indicates the level of medical judgement used to determine the existence of a problem.
If present, the code element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of 2.16.840.1.113883.10.20.22.4.4
  • have a parent element of observation
  • contain code and codeSystem attributes

    AttributeValuePurpose

    code

    Must include an alphanumeric string of any length. Could be one of the following:

    • 404684003 - Finding
    • 409586006 - Complaint
    • 282291009 - Diagnosis
    • 75321-0 - Clinical Finding
    • 75325-1 - Symptom 

    Describes the level of medical judgement used to determine the existence of a problem.

    codeSystem

    Must have a value of 2.16.840.1.113883.6.96 or

    2.16.840.1.113883.6.1 

    Identifies the SNOMED CT or LOINC coding system used to translate the identifier provided in the code attribute.

displayName and codeSystemName are not required for processing.

 

 

For accurate processing, we except to see code with code and codeSystem attributes, as documented above. However <code nullFlavor="UNK"/>or <code nullFlavor="OTH"/> is acceptable.

If code is populated with nullFlavor="OTH", a child element of translation must be present and contain code and codeSystem attributes. Clinical Data Spaces will process the information provided here instead.

Code Example of Problem Observation code
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
				<code code="409586006" codeSystem="2.16.840.1.113883.6.96" displayName="Complaint"/>
			</observation>
		</entryRelationship>			
   </act>
</entry>

Processing of the code element will fail if it does not contain correctly populated code and codeSystem attributes.

 

 

Problem Observation effectiveTime

XPath:section/entry/act/entryRelationship/observation/effectiveTime
Purpose:Specifies the onset date, duration, and resolution date (if known) of the problem.
If present, the effectiveTime element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of 2.16.840.1.113883.10.20.22.4.4
  • have a parent element of observation
  • contain an attribute of xsi:typevalue or nullFlavor

    AttributeValuePurpose
    xsi:type

    Must be populated with IVL_TS and effectiveTime must:

    1. have a low child element, which can be:
      • empty
      • have a nullFlavor attribute
      • have a value attribute indicating a specific date and time
    2. optionally have a high child element which can be:
      • empty
      • have a nullFlavor attribute
      • have a value attribute indicating a specific date and time
    Indicates the period over which the problem occurred. Low indicates the onset date (when the problem first occurred) and high specifies when the problem was known to be resolved. If high is not present, the problem is still active.
    valueMust be populated with a date in the format YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-ZZZZ] where +/-ZZZZspecifies the offset from Coordinated Universal Time. Indicates the specific time a problem occurred
    nullFlavor

    Must be one of the following:

    • ASKU - asked but unknown
    • MSK - masked (for sensitivity or confidentiality reasons)
    • NA - not available, system down
    • NASK - not asked
    • NAV - not available
    • NI - no information
    • OTH - other
    • UNK - unknown 
    Indicates that an attribute was required, but was not provided, and gives a reason for why the information is not present. In this case, it suggests the problem occurred, but it was not recorded when.
Code Example of Problem Observation effectiveTime
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
				<effectiveTime>
					<low value="199803"/>
				</effectiveTime>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the effectiveTime element will fail if it does not contain correctly populated xsi:typevalue OR nullFlavor attributes.

 

 

Problem Observation time

XPath:section/entry/act/entryRelationship/observation/author/time
Purpose:Specifies the time the author observed the problem
If present, the value element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of 2.16.840.1.113883.10.20.22.4.4
  • have a parent element of author
  • contain a value attribute

    AttributeValuePurpose
    valueMust be populated with a date in the format YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-ZZZZ] where +/-ZZZZspecifies the offset from Coordinated Universal Time. Indicates the specific time the author observed the problem
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
				<author typeCode="AUT">
					<time value="199803"/>
				</author>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the time element will fail if it does not contain a correctly populated value attributes.

 

 

 

Problem Observation value

XPath:section/entry/act/entryRelationship/observation/value
Purpose:Specifies the type of problem observed
If present, the value element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of2.16.840.1.113883.10.20.22.4.4
  • have a parent element of observation
  • contain xsi:type, code and codeSystem attributes

    AttributeValuePurpose
    xsi:typeCDIndicates that the value element is providing code and codeSystem information

    code

    Must be an alphanumerical string of any length.

    Identifies the specific problem observed

    codeSystemMust include an alphanumeric string of any length, but typically in the following format: 2.16.840.1.1113883.X.XX.X.XIdentifies the coding system used to translate the identifier provided in the code attribute
Code Example of Problem Observation value
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
				<value xsi:type="CD" code="233604007" codeSystem="2.16.840.1.113883.6.96" displayName="Pneumonia"/>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the value element will fail if it does not contain correctly populated xsi:type, code, and codeSystem attributes.

 

 

Age Observation templateId

XPath:section/entry/act/entryRelationship/observation/entryRelationship/observation/templateId
Purpose:Specifies which CCDA R2.1 template is being used to structure the age observation sub-section. R2.1 templates define the requirements, format, and structure of a CCD section. This sub-section represents the patient's age at onset of a problem or observation.
If present, the templateId element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ"
  • have a parent element of observation
  • contain a root attribute

    AttributeValuePurpose
    rootMust have a value of 2.16.840.1.113883.10.20.22.4.31Uniquely identifies the age observation template
Code Example of Age Observation templateId
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
					<entryRelationship typeCode="SUBJ">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.31"/>
						</observation>
					</entryRelationship>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

The entire problem observation sub-section is ignored if the templateId element is not provided with a root attribute of 2.16.840.1.113883.10.20.22.4.31.The information provided in this sub-section will not be processed and you will not receive any notification that this sub-section was ignored.

 

 

Age Observation code

XPath:section/entry/act/entryRelationship/observation/entryRelationship/observation/code
Purpose:Identifies that the age represented in this sub-section is the age at onset
If present, the code element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of: 2.16.840.1.113883.10.20.22.4.31
  • have a parent element of observation
  • contain code and codeSystem attributes

    AttributeValuePurpose

    code

    Must have a value of 445518008

    Identifies that the age represented is the age of onset

    codeSystem

    Must have a value of 2.16.840.1.113883.6.96

    Identifies the SNOMED CT coding system used to translate the identifier provided in the code attribute

    displayName and codeSystemName are not required for processing

Code Example of Age Observation code
 <entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
					<entryRelationship typeCode="SUBJ">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.31"/>
							<code code="397659008" codeSystem="2.16.840.1.113883.6.96" displayName="Age"/>
						</observation>
					</entryRelationship>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the code element will fail if it does not contain correctly populated code and codeSystem attributes.

 

 

Age Observation value

XPath:section/entry/act/entryRelationship/observation/entryRelationship/observation/value
Purpose:Provides the age at time of onset in a physical quantity
If present, the value element must:
  • be contained within an entryRelationship element with a typeCode attribute of "SUBJ", which has a templateId of 2.16.840.1.113883.10.20.22.4.31
  • have a parent element of observation
  • contain xsi:type, value and unit attributes

    AttributeValuePurpose
    xsi:typeMust have a value of PQIndicates that the value element is providing physical quantity information (in this case, age, in a numerical value and unit of measure)
    valueMust have an alphanumeric valueRepresents the age value (for example, 50)
    unit

    Must be one of the following:

    • min (minute)
    • h (hour)
    • d (day)
    • wk (week)
    • mo (month)
    • a (year)

    Represents the age value unit (for example, a)

    Note:

    • If value="47" and unit="a", the patient is 47 years old.
    • If value="18" and unit="mo", the patient is 18 months old.
Code Example of Age Observation value
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
					<entryRelationship typeCode="SUBJ">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.31"/>
							<value xsi:type="PQ" value="57" unit="a"/>
						</observation>
					</entryRelationship>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the value element will fail if it does not contain correctly populated xsi:type, value, and unit attributes.

 

 

Priority Preference templateId

XPath:section/entry/act/entryRelationship/observation/entryRelationship/observation/templateId
Purpose:Specifies which CCDA R2.1 template is being used to structure the priority preference sub-section. R2.1 templates define the requirements, format, and structure of a CCD section. This sub-section represents priority preference chosen by a patient or a care provider, relative to options for care or treatment, or the prioritization of concerns or problems.
If present, the templateId element must:
  • be contained within an entryRelationship element with a typeCode attribute of "REFR"
  • have a parent element of observation
  • contain a root attribute

    AttributeValuePurpose

    root

    Must have a value of 2.16.840.1.113883.10.20.22.4.143

    Uniquely identifies the priority preference sub-section

Code Example of Priority Preference templateId
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
					<entryRelationship typeCode="REFR">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.143"/>
						</observation>
					</entryRelationship>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

The entire priority preference sub-section is ignored if the templateId element is not provided with a root attribute of 2.16.840.1.113883.10.20.22.4.143.The information provided in this sub-section will not be processed and you will not receive any notification that this sub-section was ignored.

 

 

Priority Preference value

XPath:section/entry/act/entryRelationship/observation/entryRelationship/observation/value
Purpose:Specifies the priority placed on the problem observed
If present, the code element must:
  • be contained within an entryRelationship element with a typeCode attribute of "REFR", which has a templateId of 2.16.840.1.113883.10.20.22.4.143
  • have a parent element of observation
  • contain xsi:type, code and codeSystem attributes

    AttributeValuePurpose
    xsi:typeCDIndicates that the value element is providing code and codeSystem information

    code

    Must be an alphanumerical string of any length. Could be one of the following:

    • 394849002 - High priority
    • 394848005 - Normal priority
    • 441808003 - Delayed priority

    Identifies the specific priority placed on the problem observed within this encounter

    codeSystemMust have a value of: 2.16.840.1.113883.6.96Identifies the SNOMED CT coding system used to translate the identifier provided in the code attribute
Code Example of Priority Preference code
<entry typeCode="DRIV">   
   <act classCode="ACT" moodCode="EVN">
     	<templateId root="2.16.840.1.113883.10.20.22.4.3"/>
		<entryRelationship typeCode="SUBJ"/>
			<observation classCode="OBS" moodCode="EVN">
				<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
					<entryRelationship typeCode="REFR">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.143"/>
							<value xsi:type="CD" code="394849002" codeSystem="2.16.840.1.113883.6.96"/>
						</observation>
					</entryRelationship>
			</observation>
		</entryRelationship>			
   </act>
</entry> 

Processing of the value element will fail if it does not contain correctly populated xsi:type,code, and codeSystem attributes.

 

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