Updated 2022 CMS QRDA Category I Implementation Guide and Hybrid Measure Schematrons and Sample Files for Hospital Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has posted updates to the 2022 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide (IG), Schematrons, and Sample Files for Hospital Quality Reporting (HQR). The 2022 CMS QRDA I IG outlines requirements for eligible hospitals and critical access hospitals to report electronic clinical quality measures (eCQMs) for the calendar year 2022 reporting period.

Changes to the 2022 CMS QRDA I IG:

• Updated Table 3: recordTarget Constraints Overview to display all applicable rows in the correct order. There are no changes to conformance rules, these rows were inadvertently out of order in the v1.0 publication.
• Added guidance to section 5.3.1 Validation Rules for Encounter Performed to document the assertion rule enforcing the allowance of only ONE “Encounter Diagnosis QDM” template with a rank attribute equal to 1. CMS released this assertion rule in December 2020. This enforcement is in alignment with guidance provided in section 3.19 in the QRDA I Standard for Trial Use  Release 5.2 IG with errata, which states “When there are multiple diagnoses, only one diagnosis should be identified as principal diagnosis.”
• Added two new conformance statements to Table 14: Other Validation Rules for HQR Programs. These validation rules have been added to ensure data integrity of DateTime values and are part of the additional validations are implemented in the Hospital Quality Reporting (HQR) System. These validation rules are not part of the CMS schematrons.
  • CMS_0087: Low date is after high date
  • CMS_0088: Invalid DateTime has been provided

Changes to the 2022 CMS QRDA I Schematrons and Sample files:

• Updated the sample file previously named: “2022-CMS-QRDA-I-v1.0_HWR-Hybrid-CCDE-Sample-File-05052021”.
  • Updated the sample file to include the Hybrid Hospital-Wide (All-Condition, All-Procedure) Risk-Standardized Mortality Measure (HWM) measure and the additional Core Clinical Data Element, platelet count, specified for HWM.
  • Renamed the sample file to: “2022-CMS-QRDA-I-v1.1-Hybrid-CCDE-Sample-File”
• There are no other updates to files within the .zip.

Additional QRDA-Related Resources:

Find additional QRDA-related resources, as well as current and past IGs, on the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA page.

For questions related to the QRDA IGs, Schematrons, or Sample Files 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.