United States Health Information Knowledgebase



Definition:This module contains a comment to be supplied for any other entry Content Modules. See the HL7 Continuity of Care Document Section 4.3 for constraints applicable to this module.
CDA Data Location HITSP Data Element Identifier and Name O/R Additional Specification
cda:act[cda:templateId/@root = '2.16.840.1.113883.'] Comment O/Y
ancestor-or-self::./cda:author[1] Author R/N
cda:text/cda:reference/@value 11.01 - Free Text Comment R/N
cda:entryRelationship[@typeCode='RSON']/ cda:act[cda:templateId/@root= '2.16.840.1.113883.'] 11.02 - Reason O/N

Optionality Legend: “R” for Required, “R2” for Required if known, “O” for Optional and Repeat = “Y” for Yes or “N” for No

Comment Example

<!-- These examples assume the default namespace is 'urn:hl7-org:v3' -->
<act><!-- could also be observation, substanceAdministration, supply, et cetera -->
<entryRelationship typeCode='SUBJ' inversionInd='true'>
<act classCode='ACT' moodCode='EVN'>
<templateId root='2.16.840.1.113883.'/>
<templateId root='2.16.840.1.113883.'/>
<templateId root=''/>
<code code='' displayName='Annotation Comment' codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
<text><reference value='#comment-1'/></text>

Section ID Constraint ID Definition Comments Module Constraints Not Provided
C83-[DE-10-CDA-1] Data elements defined elsewhere in the specification SHALL NOT be recorded using the Comments Module.
C83-[DE-10-CDA-2] A CDA Document SHALL declare conformance for the Comments module by including a be recorded <templateID> element with the root attribute set to the value 2.16.840.1.113883.
C83-[DE-10-CDA-3] Each comment module attribute set to the value 2.16.840.1.113883. SHALL be conformant with the IHE Comment module and SHALL include a <templateID> element with the root attribute set to the value Free Text Comment Constraints Comments are free text data that cannot otherwise be recorded using data elements already defined by this specification. They are not to be used to record information that can be recorded elsewhere. For example, a free text description of the severity of an allergic reaction would not be recorded in a comment. Instead, it would be recorded using data element 6.07 defined above.
C83-[DE-10-CDA-4] The author of a comment SHALL be recorded as specified for authors in the Information Source module. Reason Reasons can be associated with many different events, including treatment events such as procedures or the use of medications or immunizations, encounters, performance of a diagnostic test, etc. The general pattern for including a reason in a CDA document appears below. The content of the of the <entryRelationship> element includes an appropriate act describing the particular reason that the outer element was (or was not) performed.

Reason Example:

<cda:entryRelationship typeCode='RSON'>
. . .
C32-[CT1--3] Comment See HITSP/C83 Section Comment
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