Now Available: Updated 2023 and 2024 CMS QRDA I Implementation Guides (IGs), Schematrons, and Sample Files for Hospital Quality Reporting (HQR)

The Centers for Medicare & Medicaid Services (CMS) has posted updates to the 2023 and 2024 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guides (IGs), Schematrons, and Sample Files for Hospital Quality Reporting (HQR).  The 2023 and 2024 CMS QRDA I IGs outline requirements for eligible hospitals and critical access hospitals (CAHs) to report electronic clinical quality measures (eCQMs) for the calendar year 2023 and 2024 reporting periods, respectively, for the Hospital Inpatient Quality Reporting (IQR) Program, the Medicare Promoting Interoperability Program, and the Outpatient Quality Reporting (OQR) Program.

Changes to the 2023 CMS QRDA I IG:

• Updated Table 14: Other Validation Rules for HQR Programs
  • Revised error message and description for CMS_0074
  • Removed CMS_0085 and CMS_0086
  • Added back the previous CMS_0084
  • Added new validation rule CMS_0089
• Updated Table 26: Key Elements for Determining Data Uniqueness to remove the row for “Other Encounter” 

Changes to 2023 CMS QRDA Schematron and Sample Files:

• Schematrons have been updated to resolve an issue identified in the HL7 QRDA I 5.3 schematron that allowed multiple Encounter Diagnoses to have a rank of 1.
• There are no updates to the 2023 CMS QRDA I sample files.

Changes to the 2024 CMS QRDA I IG:

• Updated Table 13: Other Validation Rules for HQR Programs
  • Revised error message and description for CMS_0074
  • Added back the previous CMS_0084
  • Removed CMS_0085 and CMS_0086
  • Added new validation rule CMS_0089
• Updated Table 25: Key Elements for Determining Data Uniqueness to remove the row for “Other Encounter” 

Changes to 2024 CMS QRDA Schematron and Sample Files:

• Schematrons have been updated to resolve an issue identified in the HL7 QRDA I 5.3 schematron that allowed multiple Encounter Diagnoses to have a rank of 1.
• The 2024 CMS QRDA I sample files have been updated to remove the optional documentationOf template.

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 IGs and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.
• See the QRDA Known Issues Dashboard for solutions under development for both QRDA I and III known technical issues. These known issues supplement the information in QRDA IGs and other supporting documents.