#### CDA Implementation Guidance Narrative Block Tags

### CDA Narrative Block

Tag Name | Allowable Attribute | Description
--- | --- | ---
<text> This tag encompassing a text section | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Styles text, such as presenting text in bold, italics underline
mediaType | mediaType is akin to mimeType. This is a fixed value in the CDA narrative block, and so can be omitted.

#### Tags allowed within <text>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>
<table>

#### Example

<text>

<paragraph>Some document text</paragraph>

</text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<content> Use this tag to wrap some text so that it can be referenced (using the ID attribute), or styled (using the styleCode attribute). This element can be used recursively. | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
revised | An indication that text has been revised from the original, as an insert or delete

#### Tags allowed within <content>

<content>
<linkHTML>
<sup>
<sub>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>

#### Example

<text>

<content styleCode="bold">Some document text appears in bold</content>

</text>

<text>

Sally has a history of <content ID="a1">Exercise Related Asthma</content> latest attack 2 weeks ago.

</text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<linkHTML> Acts similar to the HTML anchor tag. Can be used to reference identifiers that are both internal and external to the document. | name | DO NOT USE THIS
href | The reference location
rel |
rev |
title |
ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <linkHTML>

<footnote>
<footnoteRef>

#### Example

<section ID="SECT001">

<code code="10164-2" codeSystem="2.16.840.1.113883.6.1"

codeSystemName="LOINC"/>

<title>History of Present Illness</title>

<text>Mr. Smith is a 57 year old male presenting with chest

pain. He sustained a myocardial infarction 3 years ago,

...</text>

</section>

...

<section ID="SECT003">

<code code="10153-2" codeSystem="2.16.840.1.113883.6.1"

codeSystemName="LOINC"/>

<title>Past Medical History</title>

<text>History of coronary artery disease, as noted

<linkHtml href="#SECT001">above</linkHtml>.

</text>

</section>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<sub> Puts text into subscrip. |  |

#### Tags allowed within <sub>

<<NONE>>

#### Example

<text>

This is <sub>subscript</sub>

</text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<sup> Puts text into superscript |  |

#### Tags allowed within <sup>

<<NONE>>

#### Example

<text>

This is <su p>superscript</su p>

</text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<br> Used to indicate a hard line break. |  |

#### Tags allowed within <br>

<<NONE>>

#### Example

<text>This text appears on line one<br/>and this on line two</text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<footnote> Indicates a footnote, inline with the flow of text to which it is applied. | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <footnote>

<content>
<linkHTML>
<sub>
<sup>
<br>
<renderMultiMedia>
<paragraph>
<list>
<table>

#### Example

<text>This is the text for the section <footnote>this is a footnote for the section</footnote></text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<footnoteRef> The <footnoteRef> element can reference an existing footnote in the same or different CDA Narrative Block of the same document. It can be used when the same footnote is being used multiple times. The value of the footnoteRef.IDREF must be an footnote.ID value in the same document. | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
IDREF | Used to reference a previous footnote

#### Tags allowed within <footnoteRef>

<<NONE>>

#### Example

<text>This is the text for the section <footnote ID="F1">this is a footnote for the section</footnote></text>

....

<text>This another text section that references a footnote <footnoteRef IDREF="#F1"</footnoteRef></text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<renderMultiMedia> renderMultiMedia element references external multimedia that is integral to a document, and part of the attestable content of the document, and serves to show where the referenced multimedia is to be rendered. Multimedia that is simply referenced by the document and not an integral part of the document must use <linkHtml>. | referencedObject |
ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <renerMultiMedia>

<caption>

Example

<section>

<code code="ABCD" codeSystem="2..6.7.8.3.4445"

codeSystemName="MyCODESYSTEM"/>

<title>Skin exam</title>

<text>Erythematous rash, palmar surface, left index finger.

<renderMultiMedia referencedObject="MM1"/>

</text>

<entry>

<observationMedia classCode="OBS" moodCode="EVN" ID="MM1">

<id root="10.23.4567.345"/>

<value xsi:type="ED" mediaType="image/jpeg">

<reference value="left_hand_image.jpeg"/>

</value>

</observationMedia>

</entry>

</section>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<paragraph> Works the same as a HTML <p> tag | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <paragraph>

<caption>
<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>

#### Example

<text>The text section starts with some text.<p>The has a second paragraph</p><p styleCode="bold">And a third in bold</p></text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<caption> The CDA <caption> is a label for a paragraph, list, list item, table, or table cell. It can also be used within the <renderMultiMedia> element to indicate a label for referenced ObservationMedia and RegionOfInterest entries. A <caption> contains plain text and may contain links and footnotes. | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <list>

<linkHTML>
<sub>
<sup>
<footnote>
<footnoteRef>

#### Example

<section>

<code code="ABCD" codeSystem="2..6.7.8.3.4445"

codeSystemName="MyCODESYSTEM"/>

<title>Skin exam</title>

<text>Erythematous rash, palmar surface, left index finger.

<renderMultiMedia referencedObject="MM1"><caption styleCode="italics">Left index finger image</caption></renderMultiMedia>

</text>

<entry>

<observationMedia classCode="OBS" moodCode="EVN" ID="MM1">

<id root="10.23.4567.345"/>

<value xsi:type="ED" mediaType="image/jpeg">

<reference value="left_hand_image.jpeg"/>

</value>

</observationMedia>

</entry>

</section>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<list> produces an ordered (numbered) or unordered (bulleted) list. Unordered is the default. | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
listType | List cane be "ordered" or "unordered"

#### Tags allowed within <list>

<caption>
<item>

#### Example

<text>The following is a list of options<list><item>Option1</item><item>Option2</item></list></text>

<text>The following is an ordered list of options<list listType="ordered"><item>Option1</item><item>Option2</item></list></text>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<item> An item within a list | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics

#### Tags allowed within <item>

<caption>
<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>
<table>

#### Example

see above

Tag Name | Allowable Attribute | Description
--- | --- | ---
<table> A table - this acts in the same way as a HTML table | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
summary |
width | Table width
border | Deprecated in favour of styleCode
frame |
rules |
cellspacing | Deprecated in favour of styleCode
cellpadding | Deprecated in favour of styleCode

#### Tags allowed within <table>

<caption>
<col>
<colgroup>
<thead>
<tfoot>
<tbody>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<col> | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics, and for cell borders using "Lrule", "Rrule", "Toprule" and "Botrule"
span | Number of columns this cell spans
width |
align |
char |
charoff |
valign | Vertical alignment

#### Tags allowed within <col>

<<NONE>>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<colgroup> | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
span |
width |
align |
char |
charoff |
valign |

#### Tags allowed within <col>

<col>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<thead> Table header | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
align |
char |
charoff |
valign |

#### Tags allowed within <thead>

<tr>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<tfoot> table footer | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
align |
char |
charoff |
valign |

#### Tags allowed within <tfoot>

<tr>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<tbody> Table body | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
align |
char |
charoff |
valign |

#### Tags allowed within <tbody>

<tr>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<tr> Table row | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
abbr |
axis |
headers |
scope |
rowspan |
colspan |
align |
char |
charoff |
valign |

#### Tags allowed within <tr>

<th>
<td>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<th> Table head | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
abbr |
axis |
headers |
scope |
rowspan |
colspan |
align |
char |
charoff |
valign |

#### Tags allowed within <th>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>

Tag Name | Allowable Attribute | Description
--- | --- | ---
<td> Table data | ID | Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language | The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode | Used to style text in the document, such as bold, underline and italics
abbr |
axis |
headers |
scope |
rowspan |
colspan |
align |
char |
charoff |
valign |

#### Tags allowed within <td>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>