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Now Available: Updated 2021 CMS QRDA Category I Schematron for Hospital Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has posted an updated 2021 CMS Quality Reporting Document Architecture (QRDA) Category I Schematron for Hospital Quality Reporting (HQR). The Schematron provides technical instructions for eligible hospitals and critical access hospitals to report electronic clinical quality measures (eCQMs) for the calendar year 2021 reporting period for the

  • Hospital Inpatient Quality Reporting (IQR) Program
  • Medicare and Medicaid Promoting Interoperability Program for Eligible Hospitals and Critical Access Hospitals (CAHs)

The change to the 2021 CMS QRDA I Schematron is:

  • An assertion rule has been added to the Schematron that will allow only one Encounter Diagnosis Quality Data Model (QDM) template with a rank attribute equal to 1, to indicate the principal diagnosis, within an Encounter Performed template. This enforcement is in alignment with guidance provided in section 3.19 in the QRDA I STU Release 5.2 Implementation Guide with errata, which states “When there are multiple diagnoses, only one diagnosis should be identified as principal diagnosis.”

Additional QRDA-Related Resources:
To find out more about QRDA and eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center.
For questions related to the QRDA Implementation Guides and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.

Last Updated: May 24, 2023