USCDI Export for the Public

Classification Level Sort descending Data Class Data Class Description Data Element Data Element Description Applicable Standards Submitter Name Submitter Organization Submission Date
Draft USCDI V5

Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

SDOH Assessment

Screening questionnaire-based, structured evaluation for a Social Determinants of Health-related risk.

Examples include but are not limited to food, housing, and transportation security.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
Mark Savage for Gravity Project Gravity Project
Draft USCDI V5

Condition, diagnosis, or reason for seeking medical attention.

Social Determinants of Health-related health concerns, conditions, or diagnoses.

Examples include but are not limited to homelessness and food insecurity.

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
  • International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) 2023
Mark Savage for Gravity Project Gravity Project
Draft USCDI V5

Desired state to be achieved by a person or a person’s elections to guide care.

SDOH Goals

Desired future states for an identified Social Determinants of Health-related health concern, condition, or diagnosis.

Examples include but are not limited to food security, transportation security, and ability to access health care.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
Mark Savage for Gravity Project Gravity Project
Draft USCDI V5

Activity performed for or on a patient as part of the provision of care.

SDOH Interventions

Actions or services to address an identified Social Determinants of Health-related health concern, condition, or diagnosis.

Examples include but are not limited to education about food pantry program and referral to non-emergency medical transportation program.

  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
  • Current Procedural Terminology (CPT®) 2023, as maintained and distributed by the American Medical Association, for physician services and other health care services
  • Healthcare Common Procedure Coding System (HCPCS) Level II, as maintained and distributed by HHS
Mark Savage for Gravity Project Gravity Project
Draft USCDI V5

Provider-authored request for the delivery of patient care services.

 Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.

Provider-authored directive for the delivery of patient care services.

Examples include but are not limited to diagnostic imaging, laboratory tests, interventions, referrals and consultations, and do-not-resuscitate.

Joel Andress Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
Draft USCDI V5

Desired state to be achieved by a person or a person’s elections to guide care.

Person's goals, preferences, and priorities for care and treatment in case that person is unable to make medical decisions because of a serious illness or injury.

Examples include but are not limited to thoughts on cardiopulmonary resuscitation, mental health treatment preferences, and thoughts on pain management.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
Matt Elrod on behalf of ADVault, Inc. ADVault, Inc.
Draft USCDI V5

Desired state to be achieved by a person or a person’s elections to guide care.

Care Experience Preference

Person's goals, preferences, and priorities for overall experiences during their care and treatment.

Examples include but are not limited to religious beliefs, dislikes and fears, and thoughts and feelings to be shared.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
Matt Elrod on behalf of ADVault, Inc. ADVault, Inc.
Draft USCDI V5

Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Evaluation of a patient's reported use of drugs or other substances for non-medical purposes or in excess of a valid prescription.

Examples include but are not limited to substance use disorder score and substance use knowledge assessment.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
Jessica Cotto National Institute on Drug Abuse
Draft USCDI V5

The metadata, or extra information about data, regarding who created the data and when it was created.

Category of actor that participated in the creation or revision of data. 

Examples include but are not limited to provider, patient, family member, and device.

Gary Dickinson EHR Standards Consulting
Draft USCDI V5

Data related to an individual’s insurance coverage for health care.

Subscriber Identifier

Sequence of characters used to uniquely refer to the individual that selects insurance benefits.

Robert C Dieterle On behalf of the Da Vinci Project
Draft USCDI V5

Data related to an individual’s insurance coverage for health care.

Payer Identifier

Sequence of characters used to uniquely refer to an insurance payer.

Robert C Dieterle On behalf of the Da Vinci Project
Draft USCDI V5

Data related to an individual’s insurance coverage for health care.

Coverage Type

Category of health care payers, insurance products, or benefits.

Examples include but are not limited to Medicaid, commercial, HMO, Medicare Part D, and dental.​

Joel Andress Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
Draft USCDI V5

Data related to an individual’s insurance coverage for health care.

Group Identifier

Sequence of characters used to uniquely refer to a specific health insurance plan.

Robert C Dieterle On behalf of the Da Vinci Project
Draft USCDI V5

Analysis of clinical specimens to obtain information about the health of a patient.

Result Status

State or condition of a laboratory test.

Maria Michaels CDC
Draft USCDI V5

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions.

Clinical Test

Non-imaging or non-laboratory test.

Examples include but are not limited to electrocardiogram (ECG), visual acuity exam, macular exam, and graded exercise testing (GXT).

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
Joel Andress Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
Draft USCDI V5

Tests that result in visual images requiring interpretation by a credentialed professional.

Diagnostic Imaging Test

Tests that generate visual images and require interpretation by qualified professionals.

Examples include but are not limited to computed tomography-head, radiograph-chest, and ultrasound-pelvis.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.76
Swapna Abhyankar Regenstrief Institute, LOINC Document Ontology Subcommittee
Draft USCDI V5

Tests that result in visual images requiring interpretation by a credentialed professional.

Diagnostic Imaging Report

Interpreted results of imaging tests.

Usage Note: Includes structured and unstructured (narrative) components.

Swapna Abhyankar Regenstrief Institute, LOINC Document Ontology Subcommittee
Draft USCDI V5

Analysis of clinical specimens to obtain information about the health of a patient.

Specimen Source Site

Body location from where a specimen was obtained.

Examples include but are not limited to right internal jugular, left arm, and right eye.

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
Nedra Garrett Centers for Disease Control and Prevention
Draft USCDI V5

Analysis of clinical specimens to obtain information about the health of a patient.

Specimen Type

Substance being sampled or tested.

Examples include but are not limited to nasopharyngeal swab, whole blood, serum, urine, and wound swab. 

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
Nedra Garrett Centers for Disease Control and Prevention
Draft USCDI V5

Activity performed for or on a patient as part of the provision of care.

Reason for Referral

Explanation or justification for a referral or consultation.

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2023 Release
  • International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) 2023
Adam Bazer, MPD Integrating the Healthcare Enterprise USA (IHE USA)