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<section>
<!-- This is an example of how to affirmatively assert there is no functional impairment -->
<!-- Note that in C-CDA 1.1, functional and cognitive status (mental) are within the same section -->
<!-- If no information is known (i.e. assessment not performed), then a pattern of null entries would be more appropriate -->
<!-- This example uses terminology to assert 'No Impairment' rather than 'Impairment' and negationInd='true' (as value.negationInd) since template design didn't include guidance on negation. -->
<!-- The test data also included the No Impairment code. -->
<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_Type1">Functional Status</td>
<td>August 15 2012, 5:32pm</td>
<td ID="FS_Finding1">No impairment</td>
<td/>
</tr>
</tbody>
</table>
</text>
<entry>
<observation classCode="OBS" moodCode="EVN">
<!-- Template for Functional Status Result Observation. Note other templates may apply. -->
<!-- We chose to use terminology to state 'no impairment' over negation since the C-CDA Functional Status template design didn't include guidance on negation-->
<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"/>
</originalText>
</code>
<text>
<reference value="#FS_Narrative1"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20120815173215+0500"/>
</effectiveTime>
<value xsi:type="CD" code="66557003" codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT" displayName="No Impairment">
<originalText>
<reference value="#FS_Finding1"/>
</originalText>
</value>
</observation>
</entry>
</section>