description: 'This template is used to represent the details of current and historical procedures performed on or for a patient. A procedure is an activity that is performed on, with, or for a patient as part of the provision of care. Examples include surgical procedures, diagnostic procedures, endoscopic procedures, biopsies, counseling, physiotherapy, personal support services, adult day care services, non-emergency transportation, home modification, exercise, etc. Procedures may be performed by a healthcare professional, a service provider, a friend or relative or in some cases by the patient themselves.\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**Optional EntryRelationships**: [AssessmentScaleObservation](StructureDefinition-AssessmentScaleObservation.html), [EntryReference](StructureDefinition-EntryReference.html), [Indication](StructureDefinition-Indication.html), [InstructionObservation](StructureDefinition-InstructionObservation.html), [MedicationActivity](StructureDefinition-MedicationActivity.html), [ReactionObservation](StructureDefinition-ReactionObservation.html), [UDIOrganizer](StructureDefinition-UDIOrganizer.html)' package_name: hl7.cda.us.ccda derivation: constraint name: ProcedureActivityProcedure type: http://hl7.org/cda/stds/core/StructureDefinition/Procedure elements: entryRelationship: index: 46 slicing: rules: open discriminator: - {path: act, type: profile} - {path: observation, type: profile} - {path: substanceAdministration, type: profile} - {path: encounter, type: exists} - {path: organizer, type: profile} min: null slices: udiOrganizer: match: {} schema: short: entryRelationship array: true index: 47 elements: typeCode: pattern: {type: Code, value: COMP} index: 48 encounter: {index: 49} organizer: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Organizer', index: 50} required: [organizer] encounter: match: {} schema: short: entryRelationship array: true index: 51 elements: typeCode: pattern: {type: Code, value: COMP} index: 52 inversionInd: pattern: {type: Boolean, value: true} index: 53 encounter: index: 54 elements: classCode: {index: 55} moodCode: pattern: {type: Code, value: EVN} index: 56 id: {short: 'Set the encounter ID to the ID of an encounter in another section to signify they are the same encounter (CONF:4515-16843).', index: 57} required: [id] required: [inversionInd, encounter] instruction: match: {} schema: short: entryRelationship array: true index: 58 elements: typeCode: pattern: {type: Code, value: SUBJ} index: 59 inversionInd: pattern: {type: Boolean, value: true} index: 60 encounter: {index: 61} observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 62} required: [inversionInd, observation] indication: match: {} schema: short: entryRelationship array: true index: 63 elements: typeCode: pattern: {type: Code, value: RSON} index: 64 encounter: {index: 65} observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 66} required: [observation] medication: match: {} schema: short: entryRelationship array: true index: 67 elements: typeCode: pattern: {type: Code, value: COMP} index: 68 encounter: {index: 69} substanceAdministration: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration', index: 70} required: [substanceAdministration] reaction: match: {} schema: short: entryRelationship array: true index: 71 elements: typeCode: pattern: {type: Code, value: COMP} index: 72 encounter: {index: 73} observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 74} required: [observation] assessmentScaleObs: match: {} schema: short: When an Assessment Scale Observation is contained in a Procedure Template instance that is a Social Determinant of Health intervention procedure, that Assessment scale **MAY** contain Assessment Scale observations that represent LOINC question and answer pairs from SDOH screening instruments. array: true index: 75 elements: typeCode: pattern: {type: Code, value: RSON} index: 76 encounter: {index: 77} observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 78} required: [observation] entryReference: match: {} schema: short: When an Entry Reference Template is contained in a Procedure Template instance that is a Social Determinant of Health procedure, that Entry Reference **MAY** refer to Assessment Scale Observation in the same document that represent LOINC question and answer pairs from SDOH screening instruments. array: true index: 79 elements: typeCode: pattern: {type: Code, value: RSON} index: 80 act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 81} encounter: {index: 82} required: [act] priorityCode: binding: {strength: required, valueSet: 'http://terminology.hl7.org/ValueSet/v3-ActPriority'} index: 19 specimen: short: This specimen is for representing specimens obtained from a procedure (CONF:4515-16842). index: 22 elements: specimenRole: constraint: should-id: {human: SHOULD contain id, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: id.exists()} index: 23 elements: id: {short: 'If you want to indicate that the Procedure and the Results are referring to the same specimen, the Procedure/specimen/specimenRole/id **SHOULD** be set to equal an Organizer/specimen/specimenRole/id (CONF:4515-29744).', index: 24} participant: index: 39 slicing: rules: open discriminator: - {path: typeCode, type: value} min: null slices: serviceDeliveryLocation: match: {typeCode: LOC} schema: short: participant array: true index: 40 elements: typeCode: pattern: {type: Code, value: LOC} index: 41 participantRole: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole', index: 42} productInstance: match: {typeCode: DEV} schema: short: participant array: true index: 43 elements: typeCode: pattern: {type: Code, value: DEV} index: 44 participantRole: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole', index: 45} classCode: {index: 4} methodCode: {short: 'MethodCode **SHALL NOT** conflict with the method inherent in Procedure / code (CONF:4515-7890).', index: 20} author: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Author', short: SHOULD contain author, index: 38} id: {index: 6} targetSiteCode: short: In the case of an implanted medical device, targetSiteCode is used to record the location of the device, in or on the patient's body. binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9'} index: 21 code: short: '𝗨𝗦𝗖𝗗𝗜: SDOH Interventions' binding: {strength: preferred, valueSet: 'http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code'} constraint: should-otext-ref-value: {human: SHOULD contain originalText/reference/@value, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: originalText.reference.value.exists()} index: 7 elements: originalText: short: SHOULD reference the portion of narrative corresponding to this code index: 8 elements: reference: constraint: value-starts-octothorpe: {human: 'If reference/@value is present, it SHALL begin with a ''#'' and SHALL point to its corresponding narrative', source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: error, expression: value.exists() implies value.startsWith('#')} index: 9 moodCode: pattern: {type: Code, value: EVN} index: 5 effectiveTime: short: '𝗨𝗦𝗖𝗗𝗜: Performance Time' constraint: should-value: {human: SHOULD contain value, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: value.exists()} ts-value-before-document: {human: Time value must be equal to or before ClinicalDocument/effectiveTime, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: error, expression: value.exists() implies (value <= %resource.effectiveTime.value).allTrue()} index: 15 elements: value: {short: Indicates historical procedure or an instance of a procedure where precision may be only a date or even a year., index: 16} low: short: Indicates when a procedure started constraint: ts-value-before-document: {human: Time value must be equal to or before ClinicalDocument/effectiveTime, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: error, expression: value.exists() implies (value <= %resource.effectiveTime.value).allTrue()} index: 17 high: {short: 'Indicates when a procedure ended. If the statusCode=''active'', this must be after the ClinicalDcument/effectiveTime', index: 18} templateId: index: 0 slicing: rules: open discriminator: - {path: root, type: value} - {path: extension, type: value} min: 1 slices: procedure: match: {root: 2.16.840.1.113883.10.20.22.4.14, extension: '2024-05-01'} schema: _required: true index: 1 elements: root: pattern: {type: String, value: 2.16.840.1.113883.10.20.22.4.14} index: 2 extension: pattern: {type: String, value: '2024-05-01'} index: 3 required: [root, extension] extensions: {} statusCode: index: 12 elements: nullFlavor: {index: 13} code: binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.22'} index: 14 required: [code] performer: short: SHOULD contain performer index: 25 elements: assignedEntity: constraint: should-assignedPerson: {human: SHOULD contain assignedPerson, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: assignedPerson.exists()} should-representedOrganization: {human: SHOULD contain representedOrganization, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: representedOrganization.exists()} index: 26 elements: id: {index: 27} sdtcSpecialty: binding: {strength: preferred, valueSet: 'http://hl7.org/fhir/ValueSet/c80-practice-codes'} index: 28 addr: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/AD', index: 29} telecom: {index: 30} assignedPerson: short: SHOULD contain assignedPerson index: 31 elements: name: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/PN', index: 32} required: [name] representedOrganization: short: SHOULD contain representedOrganization constraint: should-id: {human: SHOULD contain id, source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: warning, expression: id.exists()} index: 33 elements: id: {index: 34} name: {index: 35} telecom: {index: 36} addr: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/AD', index: 37} required: [addr, telecom] required: [addr, telecom] text: short: SHOULD reference the portion of section narrative text corresponding to this entry index: 10 elements: reference: constraint: value-starts-octothorpe: {human: 'If reference/@value is present, it SHALL begin with a ''#'' and SHALL point to its corresponding narrative', source: 'http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure', severity: error, expression: value.exists() implies value.startsWith('#')} index: 11 package_version: 5.0.0 class: logical kind: logical url: http://hl7.org/cda/us/ccda/StructureDefinition/ProcedureActivityProcedure base: http://hl7.org/cda/stds/core/StructureDefinition/Procedure version: 5.0.0 required: [id, effectiveTime, statusCode, templateId, code]