Relates to CMS-1835/1963

Our question relates to the response posted to CMS-1936:
"We apologize for the delay in responding to this issue. We were able to confirm with CMS that CMS submission systems will accept null values the codes for value sets that are negated in the 2015 annual update, which corresponds to the 2016 Performance/Reporting period for all datatypes with the exception of "Device, Not Done". This is due to a standards misalignment issue in the Clinical Document Architecture which will be corrected at a future date. For "Device, Not Done" guidance please refer to the CMS QRDA Implementation Guide."

And the 'Electronic Clinical Quality Measure Logic and Implementation Guidance Version 1.12': in section 5.8-Activities That Were “Not Done”-- it states the following: "The intent of the null flavor in this context is to specify that ALL the activities in the value set were intentionally not done, not that a single activity was not done or that it is not known why that activity was not completed."

Based on the two references listed above, we would like to clarify whether a hospital could submit a specific code in the "ingredient specific" value set if members of the value set are negated or will CMS only accept the submission of a ‘nullFlavor code’ instead of a specific code from the value set for value sets that are negated in the 2015 annual update? This would be a big undertaking for vendors to change the code at this late date.

Your guidance is appreciated