FHIR IG analytics| Package | hl7.cda.us.ccda |
| Resource Type | StructureDefinition |
| Id | StructureDefinition-AdvanceDirectivesSection.json |
| FHIR Version | R5 |
| Source | https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-AdvanceDirectivesSection.html |
| URL | http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectivesSection |
| Version | 5.0.0-ballot |
| Status | draft |
| Date | 2025-12-12T18:56:41+00:00 |
| Name | AdvanceDirectivesSection |
| Title | Advance Directives Section |
| Realm | us |
| Authority | hl7 |
| Description | This section contains details about the patient’s advance healthcare directives, including references to supporting documents such as Living Wills, Healthcare Power of Attorney, Personal Advance Care Plans, DNR Orders, and Portable Medical Orders. Each type of advance directive document is represented by an individual Advance Directive Observation within a single Advance Directive Existence Observation. Each Advance Directive Observation specifies the type of advance directive and provides a unique reference for the document. Additionally, the Advance Directive Observation may include information about the document’s author and any individuals who verified the information with the patient or their healthcare agent. #### Templates Used Although open templates may contain any valid CDA content, the following templates are specifically called out by this template: **Required Entries**: [AdvanceDirectiveExistenceObservation](StructureDefinition-AdvanceDirectiveExistenceObservation.html) |
| Type | http://hl7.org/cda/stds/core/StructureDefinition/Section |
| Kind | logical |
| StructureDefinition | |
| CarePlan | Care Plan |
| ConsultationNote | Consultation Note |
| ContinuityofCareDocumentCCD | Continuity of Care Document (CCD) |
| DischargeSummary | Discharge Summary |
| HistoryandPhysical | History and Physical |
| OperativeNote | Operative Note |
| ProcedureNote | Procedure Note |
| ProgressNote | Progress Note |
| ReferralNote | Referral Note |
| TransferSummary | Transfer Summary |
| StructureDefinition | |
| Observation | Observation (CDA Class) |
| Section | Section (CDA Class) |
| AdvanceDirectiveExistenceObservation | Advance Directive Existence Observation |
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition AdvanceDirectivesSection
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Section | C | 1..1 | Section | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: shall-adv-directive-existence |
 @nullFlavor | 0..1 | cs | If a required section contains no information, the @nullFlavor MAY be set to NI | |
 Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
   templateId:section | 1..1 | II | ||
  @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.21.1 | |
  @extension | 1..1 | st | Required Pattern: 2022-02-14 | |
| code | 1..1 | CE | Advance directives | |
| @code | 1..1 | cs | Required Pattern: 42348-3 | |
 @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
| title | 1..1 | ST | Label of a section | |
| text | 1..1 | xhtml | Narrative to be rendered | |
| Slices for entry | 0..* | Entry | Slice: Unordered, Open by profile:observation, profile:organizer | |
| entry:AdvDirExistanceObservation | C | 0..* | Entry | |
 observation | 1..1 | AdvanceDirectiveExistenceObservation | 𝗨𝗦𝗖𝗗𝗜: Advance Directive Existence Observation | |
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "StructureDefinition",
"id": "AdvanceDirectivesSection",
"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": "section"
},
{
"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/AdvanceDirectivesSection",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:hl7ii:2.16.840.1.113883.10.20.22.2.21.1:2022-02-14"
}
],
"version": "5.0.0-ballot",
"name": "AdvanceDirectivesSection",
"title": "Advance Directives Section",
"status": "draft",
"date": "2025-12-12T18:56:41+00:00",
"publisher": "Health Level Seven",
"contact": [
{
"name": "HL7 International - Structured Documents",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/structure"
}
]
}
],
"description": "This section contains details about the patient’s advance healthcare directives, including references to supporting documents such as Living Wills, Healthcare Power of Attorney, Personal Advance Care Plans, DNR Orders, and Portable Medical Orders. Each type of advance directive document is represented by an individual Advance Directive Observation within a single Advance Directive Existence Observation. Each Advance Directive Observation specifies the type of advance directive and provides a unique reference for the document. Additionally, the Advance Directive Observation may include information about the document’s author and any individuals who verified the information with the patient or their healthcare agent.\n\n#### Templates Used\nAlthough open templates may contain any valid CDA content, the following templates are specifically called out by this template:\n\n**Required Entries**: [AdvanceDirectiveExistenceObservation](StructureDefinition-AdvanceDirectiveExistenceObservation.html)",
"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/Section",
"baseDefinition": "http://hl7.org/cda/stds/core/StructureDefinition/Section",
"derivation": "constraint",
"snapshot": {
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "2.0.2-sd"
}
],
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{
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"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": "shall-adv-directive-existence",
"severity": "error",
"human": "If section/@nullFlavor is not present, SHALL contain at least one Advance Directive Existence Observation",
"expression": "nullFlavor.exists() or entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectiveExistenceObservation')).exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectivesSection"
}
],
"isModifier": false,
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{
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{
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"xmlAttr"
],
"label": "Exceptional Value Detail",
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},
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{
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}
},
{
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"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": "*"
},
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{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CS"
}
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},
{
"id": "Section.typeId",
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"min": 0,
"max": "1",
"base": {
"path": "InfrastructureRoot.typeId",
"min": 0,
"max": "1"
},
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{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
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{
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"severity": "error",
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"expression": "root.exists() or nullFlavor.exists()",
"source": "http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot"
}
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{
"id": "Section.typeId.nullFlavor",
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"xmlAttr"
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{
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{
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"xmlAttr"
],
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"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.",
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"max": "1",
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{
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}
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},
{
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"path": "Section.typeId.displayable",
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"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).",
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"max": "1",
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{
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},
{
"id": "Section.typeId.root",
"path": "Section.typeId.root",
"representation": [
"xmlAttr"
],
"label": "Root",
"definition": "Identifies the type as an HL7 Registered model",
"min": 1,
"max": "1",
"base": {
"path": "II.root",
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},
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{
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"http://hl7.org/cda/stds/core/StructureDefinition/ruid"
]
}
],
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},
{
"id": "Section.typeId.extension",
"path": "Section.typeId.extension",
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"xmlAttr"
],
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},
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{
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}
]
},
{
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{
"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",
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"type": [
{
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]
},
{
"id": "Section.templateId:section",
"path": "Section.templateId",
"sliceName": "section",
"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",
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},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
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]
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{
"id": "Section.templateId:section.nullFlavor",
"path": "Section.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.",
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"max": "1",
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{
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}
],
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{
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],
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{
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],
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{
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}
],
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{
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],
"short": "Can serve as a target of a linkHtml reference",
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}
],
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}
},
{
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}
],
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},
{
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{
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"short": "Advance directives",
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},
{
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],
"label": "Exceptional Value Detail",
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"min": 0,
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"base": {
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{
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]
}
],
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}
},
{
"id": "Section.code.code",
"path": "Section.code.code",
"representation": [
"xmlAttr"
],
"label": "Code",
"definition": "The plain code symbol defined by the code system. For example, \"784.0\" is the code symbol of the ICD-9 code \"784.0\" for headache.",
"min": 1,
"max": "1",
"base": {
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},
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}
],
"patternCode": "42348-3"
},
{
"id": "Section.code.codeSystem",
"path": "Section.code.codeSystem",
"representation": [
"xmlAttr"
],
"label": "Code System",
"definition": "Specifies the code system that defines the code.",
"min": 1,
"max": "1",
"base": {
"path": "CD.codeSystem",
"min": 0,
"max": "1"
},
"type": [
{
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}
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},
{
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"xmlAttr"
],
"label": "Code System Name",
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"min": 0,
"max": "1",
"base": {
"path": "CD.codeSystemName",
"min": 0,
"max": "1"
},
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{
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"profile": [
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]
}
]
},
{
"id": "Section.code.codeSystemVersion",
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"representation": [
"xmlAttr"
],
"label": "Code System Version",
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"min": 0,
"max": "1",
"base": {
"path": "CD.codeSystemVersion",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
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]
}
]
},
{
"id": "Section.code.displayName",
"path": "Section.code.displayName",
"representation": [
"xmlAttr"
],
"label": "Display Name",
"definition": "A name or title for the code, under which the sending system shows the code value to its users.",
"min": 0,
"max": "1",
"base": {
"path": "CD.displayName",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
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]
}
]
},
{
"id": "Section.code.sdtcValueSet",
"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": "valueSet"
}
],
"path": "Section.code.sdtcValueSet",
"representation": [
"xmlAttr"
],
"definition": "The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.",
"min": 0,
"max": "1",
"base": {
"path": "CD.valueSet",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/oid"
]
}
]
},
{
"id": "Section.code.sdtcValueSetVersion",
"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": "valueSetVersion"
}
],
"path": "Section.code.sdtcValueSetVersion",
"representation": [
"xmlAttr"
],
"definition": "The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.",
"min": 0,
"max": "1",
"base": {
"path": "CD.sdtcValueSetVersion",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/st-simple"
]
}
]
},
{
"id": "Section.code.originalText",
"path": "Section.code.originalText",
"label": "Original Text",
"definition": "The text or phrase used as the basis for the coding.",
"min": 0,
"max": "1",
"base": {
"path": "CD.originalText",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/ED"
}
]
},
{
"id": "Section.code.qualifier",
"path": "Section.code.qualifier",
"label": "Qualifier",
"definition": "Specifies additional codes that increase the specificity of the the primary code.",
"min": 0,
"max": "0",
"base": {
"path": "CD.qualifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CR"
}
]
},
{
"id": "Section.code.translation",
"path": "Section.code.translation",
"representation": [
"typeAttr"
],
"label": "Translation",
"definition": "A set of other concept descriptors that translate this concept descriptor into other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CD.translation",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CD"
}
]
},
{
"id": "Section.title",
"path": "Section.title",
"short": "Label of a section",
"requirements": "If valued, it is to be rendered as part of the narrative content of the clinical document body.",
"min": 1,
"max": "1",
"base": {
"path": "Section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/ST"
}
]
},
{
"id": "Section.text",
"path": "Section.text",
"representation": [
"cdaText"
],
"short": "Narrative to be rendered",
"comment": "Also referred to as the CDA Narrative Block",
"min": 1,
"max": "1",
"base": {
"path": "Section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "xhtml"
}
]
},
{
"id": "Section.confidentialityCode",
"path": "Section.confidentialityCode",
"short": "Controls the disclosure of information in this section",
"requirements": "A value for Section.confidentialityCode overrides the value propagated from StructuredBody.",
"min": 0,
"max": "1",
"base": {
"path": "Section.confidentialityCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CE"
}
]
},
{
"id": "Section.languageCode",
"path": "Section.languageCode",
"short": "Human language of character data",
"requirements": "A value for Section.languageCode overrides the value propagated from StructuredBody.",
"min": 0,
"max": "1",
"base": {
"path": "Section.languageCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/CS"
}
],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"id": "Section.subject",
"path": "Section.subject",
"short": "Primary target of the entries recorded in a section",
"comment": "Most of the time the subject is the same as the recordTarget, but need not be, for instance when the subject is a fetus observed in an obstetrical ultrasound.",
"requirements": "The subject participant can be ascribed to a CDA section or a CDA entry. It propagates to nested components, unless overridden. The subject of a document is presumed to be the patient.",
"min": 0,
"max": "1",
"base": {
"path": "Section.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Subject"
}
]
},
{
"id": "Section.author",
"path": "Section.author",
"requirements": "The author participant can be ascribed to a CDA section, where it overrides the value(s) propagated from the CDA header.",
"min": 0,
"max": "*",
"base": {
"path": "Section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Author"
}
]
},
{
"id": "Section.informant",
"path": "Section.informant",
"requirements": "The informant participant can be ascribed to a CDA section where it overrides the value(s) propagated from the CDA header.",
"min": 0,
"max": "*",
"base": {
"path": "Section.informant",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Informant"
}
]
},
{
"id": "Section.entry",
"path": "Section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "observation"
},
{
"type": "profile",
"path": "organizer"
}
],
"rules": "open"
},
"comment": "SHALL contain at least one [1..*] entry (CONF:1198-30235) such that it",
"min": 0,
"max": "*",
"base": {
"path": "Section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Entry"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation",
"path": "Section.entry",
"sliceName": "AdvDirExistanceObservation",
"comment": "MAY contain zero or more [0..*] entry such that it",
"min": 0,
"max": "*",
"base": {
"path": "Section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Entry"
}
],
"condition": [
"shall-adv-directive-existence"
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.nullFlavor",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.realmCode",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId.nullFlavor",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId.assigningAuthorityName",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId.displayable",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId.root",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.typeId.extension",
"path": "Section.entry.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": "Section.entry:AdvDirExistanceObservation.templateId",
"path": "Section.entry.templateId",
"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": 0,
"max": "*",
"base": {
"path": "InfrastructureRoot.templateId",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.typeCode",
"path": "Section.entry.typeCode",
"representation": [
"xmlAttr"
],
"min": 0,
"max": "1",
"base": {
"path": "Entry.typeCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"defaultValueCode": "COMP",
"binding": {
"strength": "required",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry"
}
},
{
"id": "Section.entry:AdvDirExistanceObservation.contextConductionInd",
"path": "Section.entry.contextConductionInd",
"representation": [
"xmlAttr"
],
"min": 0,
"max": "1",
"base": {
"path": "Entry.contextConductionInd",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"
]
}
],
"fixedBoolean": true
},
{
"id": "Section.entry:AdvDirExistanceObservation.act",
"path": "Section.entry.act",
"min": 0,
"max": "1",
"base": {
"path": "Entry.act",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Act"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.encounter",
"path": "Section.entry.encounter",
"min": 0,
"max": "1",
"base": {
"path": "Entry.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Encounter"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.observation",
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
"valueBoolean": true
}
],
"path": "Section.entry.observation",
"short": "𝗨𝗦𝗖𝗗𝗜: Advance Directive Existence Observation",
"comment": "SHALL contain exactly one [1..1] Advance Directive Existence Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.513:2025-05-01).",
"min": 1,
"max": "1",
"base": {
"path": "Entry.observation",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Observation",
"profile": [
"http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectiveExistenceObservation"
]
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.observationMedia",
"path": "Section.entry.observationMedia",
"min": 0,
"max": "1",
"base": {
"path": "Entry.observationMedia",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.organizer",
"path": "Section.entry.organizer",
"min": 0,
"max": "1",
"base": {
"path": "Entry.organizer",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Organizer"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.procedure",
"path": "Section.entry.procedure",
"min": 0,
"max": "1",
"base": {
"path": "Entry.procedure",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Procedure"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.regionOfInterest",
"path": "Section.entry.regionOfInterest",
"min": 0,
"max": "1",
"base": {
"path": "Entry.regionOfInterest",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.substanceAdministration",
"path": "Section.entry.substanceAdministration",
"min": 0,
"max": "1",
"base": {
"path": "Entry.substanceAdministration",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration"
}
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.supply",
"path": "Section.entry.supply",
"min": 0,
"max": "1",
"base": {
"path": "Entry.supply",
"min": 0,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Supply"
}
]
},
{
"id": "Section.component",
"path": "Section.component",
"short": "Used to nest a Section within a Section",
"requirements": "Context propagates to nested sections",
"min": 0,
"max": "*",
"base": {
"path": "Section.component",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot"
}
]
},
{
"id": "Section.component.nullFlavor",
"path": "Section.component.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": "Section.component.realmCode",
"path": "Section.component.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": "Section.component.typeId",
"path": "Section.component.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/Section"
}
]
},
{
"id": "Section.component.typeId.nullFlavor",
"path": "Section.component.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": "Section.component.typeId.assigningAuthorityName",
"path": "Section.component.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": "Section.component.typeId.displayable",
"path": "Section.component.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": "Section.component.typeId.root",
"path": "Section.component.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": "Section.component.typeId.extension",
"path": "Section.component.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": "Section.component.templateId",
"path": "Section.component.templateId",
"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": 0,
"max": "*",
"base": {
"path": "InfrastructureRoot.templateId",
"min": 0,
"max": "*"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/II"
}
]
},
{
"id": "Section.component.typeCode",
"path": "Section.component.typeCode",
"representation": [
"xmlAttr"
],
"definition": "Drawn from concept domain DocumentSectionType",
"min": 0,
"max": "1",
"base": {
"path": "Section.component.typeCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"
]
}
],
"fixedCode": "COMP"
},
{
"id": "Section.component.contextConductionInd",
"path": "Section.component.contextConductionInd",
"representation": [
"xmlAttr"
],
"min": 0,
"max": "1",
"base": {
"path": "Section.component.contextConductionInd",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean",
"profile": [
"http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"
]
}
],
"fixedBoolean": true
},
{
"id": "Section.component.section",
"path": "Section.component.section",
"min": 1,
"max": "1",
"base": {
"path": "Section.component.section",
"min": 1,
"max": "1"
},
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Section"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Section",
"path": "Section",
"constraint": [
{
"key": "shall-adv-directive-existence",
"severity": "error",
"human": "If section/@nullFlavor is not present, SHALL contain at least one Advance Directive Existence Observation",
"expression": "nullFlavor.exists() or entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectiveExistenceObservation')).exists()",
"source": "http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectivesSection"
}
]
},
{
"id": "Section.nullFlavor",
"path": "Section.nullFlavor",
"short": "If a required section contains no information, the @nullFlavor MAY be set to NI"
},
{
"id": "Section.templateId",
"path": "Section.templateId",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "root"
},
{
"type": "value",
"path": "extension"
}
],
"rules": "open"
},
"min": 1
},
{
"id": "Section.templateId:section",
"path": "Section.templateId",
"sliceName": "section",
"min": 1,
"max": "1"
},
{
"id": "Section.templateId:section.root",
"path": "Section.templateId.root",
"min": 1,
"patternString": "2.16.840.1.113883.10.20.22.2.21.1"
},
{
"id": "Section.templateId:section.extension",
"path": "Section.templateId.extension",
"min": 1,
"patternString": "2022-02-14"
},
{
"id": "Section.code",
"path": "Section.code",
"short": "Advance directives",
"min": 1
},
{
"id": "Section.code.code",
"path": "Section.code.code",
"min": 1,
"patternCode": "42348-3"
},
{
"id": "Section.code.codeSystem",
"path": "Section.code.codeSystem",
"min": 1,
"patternString": "2.16.840.1.113883.6.1"
},
{
"id": "Section.title",
"path": "Section.title",
"min": 1
},
{
"id": "Section.text",
"path": "Section.text",
"min": 1
},
{
"id": "Section.entry",
"path": "Section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "observation"
},
{
"type": "profile",
"path": "organizer"
}
],
"rules": "open"
},
"comment": "SHALL contain at least one [1..*] entry (CONF:1198-30235) such that it"
},
{
"id": "Section.entry:AdvDirExistanceObservation",
"path": "Section.entry",
"sliceName": "AdvDirExistanceObservation",
"comment": "MAY contain zero or more [0..*] entry such that it",
"min": 0,
"max": "*",
"condition": [
"shall-adv-directive-existence"
]
},
{
"id": "Section.entry:AdvDirExistanceObservation.observation",
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
"valueBoolean": true
}
],
"path": "Section.entry.observation",
"short": "𝗨𝗦𝗖𝗗𝗜: Advance Directive Existence Observation",
"comment": "SHALL contain exactly one [1..1] Advance Directive Existence Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.513:2025-05-01).",
"min": 1,
"type": [
{
"code": "http://hl7.org/cda/stds/core/StructureDefinition/Observation",
"profile": [
"http://hl7.org/cda/us/ccda/StructureDefinition/AdvanceDirectiveExistenceObservation"
]
}
]
}
]
}
}