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
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="NeckDisabilityIndexExample"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<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>
</text>
<questionnaire
value="http://example.org/Questionnaire/NeckDisabilityIndexQuestionnaire"/>
<status value="completed"/>
<subject>🔗
<reference value="Patient/PatientExample"/>
</subject>
<authored value="2026-01-15T10:30:00Z"/>
<author>🔗
<reference value="Patient/PatientExample"/>
</author>
<item>
<linkId value="ndi-1"/>
<text value="Pain intensity"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25855-0"/>
<display value="The pain is moderate at the moment."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-2"/>
<text value="Personal care (washing, dressing, etc.)"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25860-0"/>
<display
value="I can look after myself normally but it causes extra pain."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-3"/>
<text value="Lifting"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25867-5"/>
<display
value="Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed, for example on a table."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-4"/>
<text value="Reading"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25873-3"/>
<display
value="I can read as much as I want with moderate pain in my neck."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-5"/>
<text value="Headaches"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA26367-5"/>
<display value="I have moderate headaches, which come frequently."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-6"/>
<text value="Concentration"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25880-8"/>
<display
value="I have a fair degree of difficulty in concentrating when I want to."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-7"/>
<text value="Work"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25886-5"/>
<display value="I can do most of my usual work, but no more."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-8"/>
<text value="Driving"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25892-3"/>
<display
value="I can drive my car as long as I want with moderate pain in my neck."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-9"/>
<text value="Sleeping"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25898-0"/>
<display value="My sleep is mildly disturbed (1-2 hrs sleepless)."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="ndi-10"/>
<text value="Recreation"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA25904-6"/>
<display
value="I am able to engage in most, but not all of my usual recreation activities because of pain in my neck."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="total-score"/>
<answer>
<valueDecimal value="40"/>
</answer>
</item>
</QuestionnaireResponse>