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

: Neck Disability Index QuestionnaireResponse Example

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{
  "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
        }
      ]
    }
  ]
}