USCDI V3 : Clarification on Disability Status Template Requirement – C-CDA V3 Validation

[Amit Patil]

I am currently validating the 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 C-CDA document using the C-CDA V3 Validator and have encountered the following error related to the Disability Status Observation template ID:  

Result Description: The Comparing Disability Status Observation data for code LA29243-5 , Template Id Comparison : : element - template id, Root Value = 2.16.840.1.113883.10.20.22.4.505 and Extension Value = No Extension value is not present in the submitted CCDA's

As per the C-CDA Implementation Guide, this template is not mandatory. However, to bypass this validation error, it appears we must manually include the template ID in the C-CDA file—even though it’s not required per the specification.

Please confirm if this is a gap between IG and CCDA validator? or is there a need to update IG or Validator?

Looking forward to your guidance

Regards,

Amit Patil

[Nagesh Bashyam]

This is not a gap , you are required to include the templateId without extension.

 

From: edge-te...@googlegroups.com <edge-te...@googlegroups.com> on behalf of Amit Patil <amitpa...@gmail.com>
Date: Tuesday, September 9, 2025 at 7:28 AM
To: Edge Test Tool (ETT) <edge-te...@googlegroups.com>
Subject: USCDI V3 : Clarification on Disability Status Template Requirement – C-CDA V3 Validation

I am currently validating the 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 C-CDA document using the C-CDA V3 Validator and have encountered the following error related to the Disability Status Observation template ID:  

Result Description: The Comparing Disability Status Observation data for code LA29243-5 , Template Id Comparison : : element - template id, Root Value = 2.16.840.1.113883.10.20.22.4.505 and Extension Value = No Extension value is not present in the submitted CCDA's

As per the C-CDA Implementation Guide, this template is not mandatory. However, to bypass this validation error, it appears we must manually include the template ID in the C-CDA file—even though it’s not required per the specification.

Please confirm if this is a gap between IG and CCDA validator? or is there a need to update IG or Validator?

Looking forward to your guidance

 

Regards,

Amit Patil

 

 

 

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[gary.a...@gmail.com]

Hi Nagesh,

Just to clarify. Are you saying that the template without the extension should be included in addition to the one with the extension?

<templateId root="2.16.840.1.113883.10.20.22.4.505"/>

<templateId root="2.16.840.1.113883.10.20.22.4.505" extension="2023-05-01"/>  

Thanks,

Gary

[merit.g...@gmail.com]

Hi Dragon - We are seeing this same issue and I see you stated it's a requirement to include the disability status template id without the extension.    We've not been able to locate this requirement in the specs to provide to our development teams to make the change, can you please provide the reference to the requirement you are referring to?  Thank you.

On Tuesday, September 9, 2025 at 7:51:43 AM UTC-4 nagesh.bashyam (Dragon) wrote:

[merit.g...@gmail.com]

Hi Dragon, 

We are seeing this same error and that you are stating it's a requirement to include the template id without the extension, which we've been unable to locate this requirement in the specs.    So that we can provide the requirements to our development team to make the changes, can you please provide the reference you are using to support this requirement.  

Thank you,

Merit

On Tuesday, September 9, 2025 at 7:51:43 AM UTC-4 nagesh.bashyam (Dragon) wrote:

[Joe Herdliska]

Hi Dragon,

We are encountering this same error and see that you are stating it's a requirement to include the template ID without the extension. We've been unable to locate this requirement in the CDA 2.1 IG or 4.1 CG specs (e.g. a previous version of the disability status observation w/ no extension).  Can you please provide the spec reference that details this requirement to assist in our development?  Thank you greatly for your help.

On Tuesday, September 9, 2025 at 7:51:43 AM UTC-4 nagesh.bashyam (Dragon) wrote:

[Mat Davis]

Hi all - I was investigating another issue and found the following.

See if this helps or if there is still more clarity needed that you'd like Dragon to supply.

https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.1.2.html

https://build.fhir.org/ig/HL7/CDA-ccda-2.1-sd/designconsiderations.html

Thanks - Mat

[Jeff Cardenas]

The wording on these documents is just really confusing.

The text for the first link and image states that it's just for "templates that had a previous version in C-CDA R.1":
When asserting this templateId, all C-CDA 2.1 section and entry templates that had a previous version in C-CDA R1.1 SHALL include both the C-CDA 2.1 templateId and the C-CDA R1.1 templateId root without an extension. See C-CDA R2.1 Volume 1 - Design Considerations for additional detail (CONF:1198-32936).

In the Design Considerations document though, that part's missing:
When asserting this templateId, all document, section, and entry templates SHALL include a templateId root without an extension. See C-CDA R2.1 Volume 1 - Design Considerations for additional detail (CONF:1198-32936).

Which of these is the real source of truth?

From what I can find, the Disability Status Observation template was not part of R1.1 - the template with the extension is the only one that exists.

All the examples also just have a single templateId with a root and extension:
https://cdasearch.hl7.org/examples/view/Guide%20Examples/Disability%20Status%20Observation_2.16.840.1.113883.10.20.22.4.505

Someone else commented about this too:
https://groups.google.com/g/edge-test-tool/c/4MaAVM__w6M

[Mat Davis]

Definitely some good points.

1. The real source is the 2.1 documentation that is mentioned, I just happened to post a structured definition version so make sure to check the PDF version that you need to log into and download from HL7
2. Disability Status does seem recent and someone pointed that out using this resource as well - https://confluence.hl7.org/spaces/SD/pages/51227465/C-CDA+OIDs
3. I wouldn't go purely off the examples as they can be inconsistent, sometimes inaccurate and/or incomplete

We'll see how Dragon follows up here and the other thread.

I had similar questions on a different thread because the validation seemed unexpected and just not clear why it was being enforced now and to what extent.

Having links to the source of this validation will be helpful.

Thanks - Mat