CMS ACCESS Model API
0.9.8 - draft
US
This page is part of the ACCESS Model IG v0.9.8 DRAFT (v0.9.8: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "QuestionnaireResponse",
"id" : "NeckDisabilityIndexExample",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"
]
},
"language" : "en",
"text" : {
"status" : "generated",
"div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p>Neck Disability Index QuestionnaireResponse for John Doe. Total score: 40.</p></div>"
},
"questionnaire" : "http://example.org/Questionnaire/NeckDisabilityIndexQuestionnaire",
"status" : "completed",
"subject" : {
🔗 "reference" : "Patient/PatientExample"
},
"authored" : "2026-01-15T10:30:00Z",
"author" : {
🔗 "reference" : "Patient/PatientExample"
},
"item" : [
{
"linkId" : "ndi-1",
"text" : "Pain intensity",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25855-0",
"display" : "The pain is moderate at the moment."
}
}
]
},
{
"linkId" : "ndi-2",
"text" : "Personal care (washing, dressing, etc.)",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 1
}
],
"system" : "http://loinc.org",
"code" : "LA25860-0",
"display" : "I can look after myself normally but it causes extra pain."
}
}
]
},
{
"linkId" : "ndi-3",
"text" : "Lifting",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25867-5",
"display" : "Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed, for example on a table."
}
}
]
},
{
"linkId" : "ndi-4",
"text" : "Reading",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25873-3",
"display" : "I can read as much as I want with moderate pain in my neck."
}
}
]
},
{
"linkId" : "ndi-5",
"text" : "Headaches",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 3
}
],
"system" : "http://loinc.org",
"code" : "LA26367-5",
"display" : "I have moderate headaches, which come frequently."
}
}
]
},
{
"linkId" : "ndi-6",
"text" : "Concentration",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25880-8",
"display" : "I have a fair degree of difficulty in concentrating when I want to."
}
}
]
},
{
"linkId" : "ndi-7",
"text" : "Work",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25886-5",
"display" : "I can do most of my usual work, but no more."
}
}
]
},
{
"linkId" : "ndi-8",
"text" : "Driving",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25892-3",
"display" : "I can drive my car as long as I want with moderate pain in my neck."
}
}
]
},
{
"linkId" : "ndi-9",
"text" : "Sleeping",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25898-0",
"display" : "My sleep is mildly disturbed (1-2 hrs sleepless)."
}
}
]
},
{
"linkId" : "ndi-10",
"text" : "Recreation",
"answer" : [
{
"valueCoding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 2
}
],
"system" : "http://loinc.org",
"code" : "LA25904-6",
"display" : "I am able to engage in most, but not all of my usual recreation activities because of pain in my neck."
}
}
]
},
{
"linkId" : "total-score",
"answer" : [
{
"valueDecimal" : 40
}
]
}
]
}