Category Reporting Who Uses Tool Health IT Developer/Vendor Implementers Eligible Hospital and Critical Access Hospital The Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) released guidance for reporting diagnostic test data in the Diagnostic Study Performed (V4) template of Quality Reporting Document Architecture (QRDA) Category I files. This affects the electronic clinical quality measure (eCQM) CMS31v6 - Hearing Screening Prior To Hospital Discharge only. The 2018 CMS QRDA Category I Implementation Guide (IG) for Hospital Quality Reporting allows for two ways of reporting the result of a diagnostic test in the Diagnostic Study Performed (V4) template:Using the element “value” inherited from its parent template Procedure Activity Observation (V2), orUsing the contained template Result Observation (V3).For 2018 reporting, CMS has aligned with TJC to only use the first option. Result data for the Diagnostic Study Performed template must be in the value element in order to be processed by CMS.Result data provided in the template Result Observation (V3) will not be used by the QualityNet data receiving system during measure calculation of CMS31v6. The QRDA file will not be rejected, nor will a warning be returned, if the Result Observation (V3) template is used, and that the measure outcome of CMS31v6 from CMS may not match what is expected.