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  1. FHIR Specification Feedback
  2. FHIR-40903

CDA Coding <-> FHIR CodeableConcept - order of coding array

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Low Low
    • US C-CDA on FHIR (FHIR)
    • 1.2.0-ballot
    • Cross-Group Projects
    • Mapping General and Structural Guidance
    • CDA Coding <-> FHIR CodeableConcept
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      FHIR codes are not ordered, so there is no requirement that code is first and translations are 2..*.

      However, since C-CDA templates often require a particular code in the root value, will add guidance on the FHIR->C-CDA map to pay attention to the C-CDA specification when deciding whether to put each coding into either the root element or a translation.

      Will also add guidance that it is not necessary to translate nullFlavors from C-CDA to FHIR.

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      FHIR codes are not ordered, so there is no requirement that code is first and translations are 2..*. However, since C-CDA templates often require a particular code in the root value, will add guidance on the FHIR->C-CDA map to pay attention to the C-CDA specification when deciding whether to put each coding into either the root element or a translation. Will also add guidance that it is not necessary to translate nullFlavors from C-CDA to FHIR.
    • Jay Lyle/Michelle Currie: 10-0-0
    • Clarification
    • Non-substantive

    Description

      The structure for coding in CDA and FHIR are fundamentally different. CDA employs a mechanism (xsi:type CD or CE) where the code is included in the element and then originalText and translations elements may be provided as child elements. In FHIR, CodeableConcept places all codes in a coding list with a separate element for the text representation.

      It may be worth adding some additional guidance that the root @code/@codeSystem goes in the first coding array element, and then translations follow in the order they are sent in CDA. An exception would be if the root @code/@codeSystem contained a nullFlavor like 'OTH' (in the event that CDA required, for example, a SNOMED code). In this case, it doesn't make sense to populate a FHIR coding element with a null value, so it could just be omitted at this point (unless US Core required the same vocabulary).

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            benjamin Benjamin Flessner
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