| Package | hl7.cda.us.ccda |
| Resource Type | StructureDefinition |
| Id | ExternalDocumentReference |
| FHIR Version | R5 |
| Source | http://hl7.org/cda/us/ccda/https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-ExternalDocumentReference.html |
| URL | http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference |
| Version | 4.0.0 |
| Status | draft |
| Date | 2025-06-26T21:09:45+00:00 |
| Name | ExternalDocumentReference |
| Title | External Document Reference |
| Realm | us |
| Authority | hl7 |
| Description | Where it is necessary to reference an external clinical document, the External Document Reference template can be used to reference this external document. However, if the containing document is appending to or replacing another document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument. |
| Type | http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument |
| Kind | logical |
| StructureDefinition | |
| GoalObservation | Goal Observation |
| HealthConcernAct | Health Concern Act |
| InterventionAct | Intervention Act |
| OutcomeObservation | Outcome Observation |
| PlannedInterventionAct | Planned Intervention Act |
| RiskConcernAct | Risk Concern Act |
| StructureDefinition | |
| ExternalDocument | ExternalDocument (CDA Class) |
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition ExternalDocumentReference
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  ExternalDocument | C | 1..1 | ExternalDocument | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, text, setId, versionNumber, sdtcAuthor Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-setId, should-versionNumber |
  Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
   templateId:external-doc-ref | 1..1 | II | ||
  @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.115 | |
  @extension | 1..1 | st | Required Pattern: 2014-06-09 | |
| @classCode | 1..1 | cs | Fixed Value: DOCCLIN | |
| @moodCode | 1..1 | cs | ||
| id | 1..1 | II | ||
| code | 1..1 | CD | ||
| setId | 0..1 | II | ||
 versionNumber | 0..1 | INT | ||
| Documentation for this format | ||||
FHIR{
"resourceType": "StructureDefinition",
"id": "ExternalDocumentReference",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/logical-target",
"_valueBoolean": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "not-applicable"
}
]
}
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/xml-namespace",
"valueUri": "urn:hl7-org:v3"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/xml-name",
"valueString": "externalDocument"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/logical-container",
"valueUri": "http://hl7.org/cda/stds/core/StructureDefinition/ClinicalDocument"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/type-profile-style",
"valueCode": "cda"
}
],
"url": "http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09"
}
],
"version": "4.0.0",
"name": "ExternalDocumentReference",
"title": "External Document Reference",
"status": "draft",
"date": "2025-06-26T21:09:45+00:00",
"publisher": "Health Level Seven",
"contact": [
{
"name": "HL7 International - Structured Documents",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/structure"
}
]
}
],
"description": "Where it is necessary to reference an external clinical document, the External Document Reference template can be used to reference this external document. However, if the containing document is appending to or replacing another document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
],
"fhirVersion": "5.0.0",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "logical",
"abstract": false,
"type": "http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument",
"baseDefinition": "http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument",
"derivation": "constraint",
"snapshot": {
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "2.0.1-sd"
}
],
"element": [
{
"id": "ExternalDocument",
"path": "ExternalDocument",
"short": "Base for all types and resources",
"definition": "Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.",
"min": 1,
"max": "1",
"base": {
"path": "Base",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "should-setId",
"severity": "warning",
"human": "SHOULD contain setId",
"expression": "setId.exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference"
},
{
"key": "should-versionNumber",
"severity": "warning",
"human": "SHOULD contain versionNumber",
"expression": "versionNumber.exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ExternalDocument.nullFlavor",
"path": "ExternalDocument.nullFlavor",
"representation": [
"xmlAttr"
],
"label": "Exceptional Value Detail",
"definition": "If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.",
"min": 0,
"max": "1",
"base": {
"path": "ANY.nullFlavor",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"
}
},
{
"id": "ExternalDocument.realmCode",
"path": "ExternalDocument.realmCode",
"definition": "When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question",
"min": 0,
"max": "*",
"base": {
"path": "InfrastructureRoot.realmCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CS"
}
]
},
{
"id": "ExternalDocument.typeId",
"path": "ExternalDocument.typeId",
"definition": "When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.",
"min": 0,
"max": "1",
"base": {
"path": "InfrastructureRoot.typeId",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
],
"constraint": [
{
"key": "II-1",
"severity": "error",
"human": "An II instance must have either a root or an nullFlavor.",
"expression": "root.exists() or nullFlavor.exists()",
"source": "http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot"
}
]
},
{
"id": "ExternalDocument.typeId.nullFlavor",
"path": "ExternalDocument.typeId.nullFlavor",
"representation": [
"xmlAttr"
],
"label": "Exceptional Value Detail",
"definition": "If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.",
"min": 0,
"max": "1",
"base": {
"path": "ANY.nullFlavor",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"
}
},
{
"id": "ExternalDocument.typeId.assigningAuthorityName",
"path": "ExternalDocument.typeId.assigningAuthorityName",
"representation": [
"xmlAttr"
],
"label": "Assigning Authority Name",
"definition": "A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.",
"min": 0,
"max": "1",
"base": {
"path": "II.assigningAuthorityName",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/st-simple"
]
}
]
},
{
"id": "ExternalDocument.typeId.displayable",
"path": "ExternalDocument.typeId.displayable",
"representation": [
"xmlAttr"
],
"label": "Displayable",
"definition": "Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).",
"min": 0,
"max": "1",
"base": {
"path": "II.displayable",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"
]
}
]
},
{
"id": "ExternalDocument.typeId.root",
"path": "ExternalDocument.typeId.root",
"representation": [
"xmlAttr"
],
"label": "Root",
"definition": "Identifies the type as an HL7 Registered model",
"min": 1,
"max": "1",
"base": {
"path": "II.root",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/oid",
"http://hl7.org/cda/stds/core/StructureDefinition/uuid",
"http://hl7.org/cda/stds/core/StructureDefinition/ruid"
]
}
],
"fixedString": "2.16.840.1.113883.1.3"
},
{
"id": "ExternalDocument.typeId.extension",
"path": "ExternalDocument.typeId.extension",
"representation": [
"xmlAttr"
],
"label": "Extension",
"definition": "A character string as a unique identifier within the scope of the identifier root.",
"min": 1,
"max": "1",
"base": {
"path": "II.extension",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/st-simple"
]
}
]
},
{
"id": "ExternalDocument.templateId",
"path": "ExternalDocument.templateId",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "root"
},
{
"type": "value",
"path": "extension"
}
],
"rules": "open"
},
"definition": "When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question",
"min": 1,
"max": "*",
"base": {
"path": "InfrastructureRoot.templateId",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "ExternalDocument.templateId:external-doc-ref",
"path": "ExternalDocument.templateId",
"sliceName": "external-doc-ref",
"definition": "When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question",
"min": 1,
"max": "1",
"base": {
"path": "InfrastructureRoot.templateId",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "ExternalDocument.templateId:external-doc-ref.nullFlavor",
"path": "ExternalDocument.templateId.nullFlavor",
"representation": [
"xmlAttr"
],
"label": "Exceptional Value Detail",
"definition": "If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.",
"min": 0,
"max": "1",
"base": {
"path": "ANY.nullFlavor",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"
}
},
{
"id": "ExternalDocument.templateId:external-doc-ref.assigningAuthorityName",
"path": "ExternalDocument.templateId.assigningAuthorityName",
"representation": [
"xmlAttr"
],
"label": "Assigning Authority Name",
"definition": "A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.",
"min": 0,
"max": "1",
"base": {
"path": "II.assigningAuthorityName",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/st-simple"
]
}
]
},
{
"id": "ExternalDocument.templateId:external-doc-ref.displayable",
"path": "ExternalDocument.templateId.displayable",
"representation": [
"xmlAttr"
],
"label": "Displayable",
"definition": "Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).",
"min": 0,
"max": "1",
"base": {
"path": "II.displayable",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"
]
}
]
},
{
"id": "ExternalDocument.templateId:external-doc-ref.root",
"path": "ExternalDocument.templateId.root",
"representation": [
"xmlAttr"
],
"label": "Root",
"definition": "A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.",
"min": 1,
"max": "1",
"base": {
"path": "II.root",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/oid",
"http://hl7.org/cda/stds/core/StructureDefinition/uuid",
"http://hl7.org/cda/stds/core/StructureDefinition/ruid"
]
}
],
"patternString": "2.16.840.1.113883.10.20.22.4.115"
},
{
"id": "ExternalDocument.templateId:external-doc-ref.extension",
"path": "ExternalDocument.templateId.extension",
"representation": [
"xmlAttr"
],
"label": "Extension",
"definition": "A character string as a unique identifier within the scope of the identifier root.",
"min": 1,
"max": "1",
"base": {
"path": "II.extension",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/st-simple"
]
}
],
"patternString": "2014-06-09"
},
{
"id": "ExternalDocument.classCode",
"path": "ExternalDocument.classCode",
"representation": [
"xmlAttr"
],
"comment": "SHALL contain exactly one [1..1] @classCode=\"DOCCLIN\" Clinical Document (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31931).",
"min": 1,
"max": "1",
"base": {
"path": "ExternalDocument.classCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"defaultValueCode": "DOC",
"fixedCode": "DOCCLIN",
"binding": {
"strength": "required",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ActClassDocument"
}
},
{
"id": "ExternalDocument.moodCode",
"path": "ExternalDocument.moodCode",
"representation": [
"xmlAttr"
],
"comment": "SHALL contain exactly one [1..1] @moodCode=\"EVN\" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31932).",
"min": 1,
"max": "1",
"base": {
"path": "ExternalDocument.moodCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"fixedCode": "EVN",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/cda/stds/core/ValueSet/CDAActMood"
}
},
{
"id": "ExternalDocument.id",
"path": "ExternalDocument.id",
"comment": "SHALL contain exactly one [1..1] id (CONF:1098-32751).",
"min": 1,
"max": "1",
"base": {
"path": "ExternalDocument.id",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "ExternalDocument.code",
"path": "ExternalDocument.code",
"comment": "SHALL contain exactly one [1..1] code (CONF:1098-31933).",
"min": 1,
"max": "1",
"base": {
"path": "ExternalDocument.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CD"
}
],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-typecodes"
}
},
{
"id": "ExternalDocument.text",
"path": "ExternalDocument.text",
"min": 0,
"max": "1",
"base": {
"path": "ExternalDocument.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/ED"
}
]
},
{
"id": "ExternalDocument.setId",
"path": "ExternalDocument.setId",
"comment": "SHOULD contain zero or one [0..1] setId (CONF:1098-32752).",
"min": 0,
"max": "1",
"base": {
"path": "ExternalDocument.setId",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "ExternalDocument.versionNumber",
"path": "ExternalDocument.versionNumber",
"comment": "SHOULD contain zero or one [0..1] versionNumber (CONF:1098-32753).",
"min": 0,
"max": "1",
"base": {
"path": "ExternalDocument.versionNumber",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/INT"
}
]
},
{
"id": "ExternalDocument.sdtcAuthor",
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/xml-namespace",
"valueUri": "urn:hl7-org:sdtc"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/xml-name",
"valueString": "author"
}
],
"path": "ExternalDocument.sdtcAuthor",
"min": 0,
"max": "*",
"base": {
"path": "ExternalDocument.sdtcAuthor",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Author"
}
]
}
]
},
"differential": {
"element": [
{
"id": "ExternalDocument",
"path": "ExternalDocument",
"constraint": [
{
"key": "should-setId",
"severity": "warning",
"human": "SHOULD contain setId",
"expression": "setId.exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference"
},
{
"key": "should-versionNumber",
"severity": "warning",
"human": "SHOULD contain versionNumber",
"expression": "versionNumber.exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference"
}
]
},
{
"id": "ExternalDocument.templateId",
"path": "ExternalDocument.templateId",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "root"
},
{
"type": "value",
"path": "extension"
}
],
"rules": "open"
},
"min": 1
},
{
"id": "ExternalDocument.templateId:external-doc-ref",
"path": "ExternalDocument.templateId",
"sliceName": "external-doc-ref",
"min": 1,
"max": "1"
},
{
"id": "ExternalDocument.templateId:external-doc-ref.root",
"path": "ExternalDocument.templateId.root",
"min": 1,
"patternString": "2.16.840.1.113883.10.20.22.4.115"
},
{
"id": "ExternalDocument.templateId:external-doc-ref.extension",
"path": "ExternalDocument.templateId.extension",
"min": 1,
"patternString": "2014-06-09"
},
{
"id": "ExternalDocument.classCode",
"path": "ExternalDocument.classCode",
"comment": "SHALL contain exactly one [1..1] @classCode=\"DOCCLIN\" Clinical Document (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-31931).",
"min": 1,
"fixedCode": "DOCCLIN"
},
{
"id": "ExternalDocument.moodCode",
"path": "ExternalDocument.moodCode",
"comment": "SHALL contain exactly one [1..1] @moodCode=\"EVN\" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-31932).",
"min": 1
},
{
"id": "ExternalDocument.id",
"path": "ExternalDocument.id",
"comment": "SHALL contain exactly one [1..1] id (CONF:1098-32751).",
"min": 1,
"max": "1"
},
{
"id": "ExternalDocument.code",
"path": "ExternalDocument.code",
"comment": "SHALL contain exactly one [1..1] code (CONF:1098-31933).",
"min": 1
},
{
"id": "ExternalDocument.setId",
"path": "ExternalDocument.setId",
"comment": "SHOULD contain zero or one [0..1] setId (CONF:1098-32752)."
},
{
"id": "ExternalDocument.versionNumber",
"path": "ExternalDocument.versionNumber",
"comment": "SHOULD contain zero or one [0..1] versionNumber (CONF:1098-32753)."
}
]
}
}