Section 1a: Clinical Document Architecture (CDA®)
Section 2: Clinical and Administrative Domains
Section 3: Implementation Guides

HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 2 - US Realm

DESCRIPTION

This implementation guide (Guide) defines the requirements for sending and receiving standards-based electronic attachments. It does so by applying additional constraints onto standards in common use for clinical documentation and by defining requirements for sending and receiving systems for attachment request and response messages. It defines the set of attachment documents as those that contain the minimum standard metadata to support basic document management functions including identification of patients and providers, the type of document, date of creation, encounter information, and a globally unique document identifier.

ALTERNATIVE NAMES

HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 2 - US Realm may also go by the following names or acronyms:

"HL7 Attachments IG CCDA Exchange, R3", Attachment Supplemental Guide, Supplemental Attachments Guide

TARGETS

  • Regulatory Agency
  • Standards Development Organizations (SDOs)
  • Payors
  • EHR, PHR Vendors
  • Health Care IT Vendors

 

BENEFITS

  • Enables the Administrative Simplification provision of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandated the use of named healthcare electronic data interchange standards for the electronic conveyance of healthcare data that meets the business purposes specifically addressed under HIPAA.
  • Support the exchange of healthcare information between providers and payers as part of the administrative business functions of both. It describes the use of CDA Documents as Attachments to exchange clinical information between payer and provider entities. Examples of that exchange using existing standards are included. However, the Guide does not limit implementations to using only those exchange standards. This Guide offers guidance for re-associating that clinical document with the healthcare administrative activity for which additional information was originally needed.
    • Examples of Healthcare Administrative Activities requiring this supporting information include, but are not limited to:
      • healthcare claim or encounter
      • healthcare services review (e.g., prior authorizations/precertifications, referrals, notifications)
      • post adjudicated claim audits
      • pre-payment claim audits to allow for pre-payment review

IMPLEMENTATIONS/CASE STUDIES

  • National Government Services (NGS)

DEVELOPMENT BACKGROUND

This Guide is intended to be used along with the CDA Implementation Guides for Attachments and provides guidance to implementers as they develop the means for exchanging supporting information.

This Guide will serve to direct implementers to the appropriate HL7 implementation standard used to format the content based on the clinical document being exchanged as an Attachment.  Refer to the appropriate CDA Implementation Guides for Attachments for additional information regarding levels of constraint, conformance statements, conformance verbs, cardinality, vocabulary conformance, and null flavor.

This Guide is independent of the method for exchange (e.g., transport, networking, connectivity, security/privacy).

RELATED DOCUMENTS

HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 2 - US Realm

(Download) (1.12 MB)

STU DOCUMENTS

HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 1 Expiration Aug 2019

(Download) (1.25 MB)

TOPIC

  • Attachments

BALLOT TYPE

  • Informative
  • STU

STATUS DATE

2022-03-08

RESPONSIBLE WORK GROUP

Payer/Provider Information Exchange Work Group

PRODUCT TYPE

  • Implementation Guide

STAKEHOLDERS

  • EHR, PHR Vendors
  • Health Care IT Vendors
  • Payors
  • Standards Development Organizations (SDOs)

FAMILY

  • CDA

CURRENT STATE

  • Active

REALM

  • US Realm