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<section>
<!-- This is an example of how to affirmatively assert there is a functional impairment -->
<!-- Original design influenced by Transitions of Care test scenario, inpatient for MU2 170.314(b)(2)-->
<!-- Note that in C-CDA 1.1, functional and cognitive status (mental) are within the same section -->
<templateId root="2.16.840.1.113883.10.20.22.2.14"/>
<templateId root="2.16.840.1.113883.10.20.22.2.14" extension="2014-06-09"/>
<code code="47420-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Functional Status"/>
<title>Functional Status</title>
<!-- Narrative organized as a single table. Some systems may prefer simple paragraph-->
<text>
<table>
<thead>
<tr>
<th>Assessment</th>
<th>Date</th>
<th>Results</th>
<th>Comments</th>
</tr>
</thead>
<tbody>
<tr ID="FS_Narrative1">
<td ID="FS_Type">Functional Status</td>
<td>August 15 2012, 5:32pm</td>
<td ID="FS_Finding1">Dependence on walking stick</td>
<td></td>
</tr>
</tbody>
</table>
</text>
<entry>
<observation classCode="OBS" moodCode="EVN">
<!-- Template for Functional Status Observation. Note other templates may apply. -->
<templateId root="2.16.840.1.113883.10.20.22.4.67"/>
<templateId root="2.16.840.1.113883.10.20.22.4.67" extension="2014-06-09"/>
<id root="e4f9eb37-52ca-4e95-90f3-570dace107e6"/>
<code code="54522-8" displayName="Functional status" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC">
<originalText>
<reference value="#FS_Type1"></reference>
</originalText>
</code>
<text>
<reference value="#FS_Narrative1"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<!-- Some systems may just report this to day rather than hour and minute timestamp. Both of which are acceptable. -->
<low value="20120815173215-0500"/>
</effectiveTime>
<value xsi:type="CD" code="105504002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Dependence on walking stick">
<originalText>
<reference value="#FS_Finding1"/>
</originalText>
</value>
</observation>
</entry>
</section>