Each C-CDA document is scored and graded for a set of enhanced interoperability rules developed by HL7. A higher score (grade) means that information is coded with appropriate structure and semantics and hence has a better chance of interoperating with disparate systems. The maximum score is 100 points and the grades are:
- A+ (more than 94 points)
- A- (90 to 94 points)
- B+ (85 to 89 points)
- B- (80 to 84 points)
- C (70 to 79 points)
- D (less than 70 points)