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The Consolidated CDA Implementation Guiide Guide (C-CDA IG) is developed by US stakeholders through the HL7 standardization process. Version 1.1 of the Implementation guide is a requirement for Certified EHRT in the Meaningful Use Stage 2 program, and version 2.1 is required for MU3 and newer regulations.

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The document template used is NOT required and the implementer can use any appropriate valid document template type from the HL7 CCDA C-CDA R2.1 IG. The reasons we are not requiring a specific document type:

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• R = section is required and may not be null. Per HL7 CCDA C-CDA IG, the non-null / entries required template would be used. Per ONC or AMA, the data should be populated if available and an assertion of “no data available” should be populated if not available.
• RE = section is required but may be empty. Per HL7 CCDA C-CDA IG, the entries required template may be used with null indicators or entries optional template may be used. Per ONC or AMA, the data should be populated if available, appropriate, and not covered elsewhere in the document.
• O = section and data are both optional.
• * (required or optional) Addition to template means that this section or data is not explicitly listed in the HL7 CCDA C-CDA IG at all or at least as part of the document definition. The CCDA C-CDA architecture is defined so that additional sections may be added, but the rows marked as addition to template would require that addition outside the defined template definition.

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