Planned Procedure templateId for USCDI V3

[Danny Wise]

The HL7® CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes STU Companion Guide, Release 4.1 - US Realm defines a new V3 of the Planned Procedure template with an updated templateId/@extension value:

However, for the Alice Newman scenarios, the USCDI V3 validator also seems to expect the Planned Procedure V2 <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09" /> and will generate errors for documents that only assert conformance to V3:

       <templateId root="2.16.840.1.113883.10.20.22.4.41" />
       <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2022-06-01" />

Result Description: The Comparing Planned Procedure data for code 467771000124109 , Template Id Comparison : : element - template id, Root Value = 2.16.840.1.113883.10.20.22.4.41 and Extension Value = 2014-06-09 is not present in the submitted CCDA's

Interestingly, the validator also generates an error if a document only asserts conformance to V2:

       <templateId root="2.16.840.1.113883.10.20.22.4.41" />

       <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09" />

Result Description: The Comparing Planned Procedure data for code 467771000124109 , Template Id Comparison : : element - template id, Root Value = 2.16.840.1.113883.10.20.22.4.41 and Extension Value = 2022-06-01 is not present in the submitted CCDA's

To avoid these errors altogether, the document must assert conformance to both V2 and V3 of the Planned Procedure template simultaneously:

       <templateId root="2.16.840.1.113883.10.20.22.4.41" />
       <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09" />
       <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2022-06-01" />

Is this expected behavior?  This requirement for asserting conformance to multiple versions of templates doesn't seem to be present for any other templates.

[Mat Davis]

Hey Danny, great display of details here.

To my understanding, this is expected behavior and is mainly done for backwards compatibility.

Am I 100% sure on this?

No - but it's how I've always seen it done.

Should it be changed?

I think the backwards compatibility expectations are being loosened in future IGs for C-CDA and FHIR but not sure if that means they should or will do the same here in this situation.

Thanks - Mat