When a patient imported from Cypress 3.2.3 [attached imported.xml] is processed and exported after evaluating measure CMS-22 v6, [attached exported.xml] to cypress, we see that it is unable to process the entry for "Laboratory Test, Order not done: Patient Reason refused" in the denominator exception criteria. Instead, it is looking for the entry "Diagnostic Study, Order not done: Patient Reason refused" for "ECG 12 lead or study order" in the same denominator exception criteria.

While this entry does exist in the imported document, we believe the lab test order entry should be sufficient for the patient to get the same desired outcome. We're not sure why the lab test entry is not being picked up by cypress when evaluating the measure.