When submitting a QRDA Category III document for a measure with stratifications, the spec makes it clear that all stratifications must be reported, with one exception. See the following excerpt from Report Format (section 2.2), with emphasis added to the key phrase:

To ensure all data are consistently reported, all populations identified in an eMeasure should be reported, even when the number of patients in that population is zero. Likewise, all stratifications identified in an eMeasure should be reported, even when the number of patients in a stratum is zero, except for populations where the total count is zero. For the optional supplemental data elements, it is sufficient to report non-zero data, leaving out counts that are zero.

For example, in a test for CMS155, which has three Numerators and two Reporting Strata, if Numerator 3 (Physical Activity Counseling) is zero, the unstratified tally (zero) must be included in the QRDA Category III document but the two stratified values (which obviously would also be zero) are not required.

However, both Cypress 2.2.0 and Cypress 2.3.0 report errors when such a document is submitted. Here are the errors from Cypress 2.3.0:

• CMS155v1/0024 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents: HQFM_ID: 8A4D92B2-397A-48D2-0139-7CC6B5B8011E Stratification ID 95DF97E7-810D-48A5-8F02-99FA4B384A7B
  • Could not find entry for measure 8A4D92B2-397A-48D2-0139-7CC6B5B8011E with the following population ids {"IPP"=>"E83A6DA6-D34E-4107-8431-2FB2C86738C7", "DENOM"=>"A08E22DD-9B31-40AD-BA5C-5DB43F8FFBE4", "NUMER"=>"E3ACA22F-9239-417D-8074-E4882FB0F848", "DENEX"=>"FE61FF42-F9EF-4ADA-9D3F-E734B8D70E87", "stratification"=>"95DF97E7-810D-48A5-8F02-99FA4B384A7B"}
  • Could not find entry for measure 8A4D92B2-397A-48D2-0139-7CC6B5B8011E with the following population ids {"IPP"=>"E83A6DA6-D34E-4107-8431-2FB2C86738C7", "DENOM"=>"A08E22DD-9B31-40AD-BA5C-5DB43F8FFBE4", "NUMER"=>"84C557E8-41B1-43F6-8C1B-1D204335AAFB", "DENEX"=>"FE61FF42-F9EF-4ADA-9D3F-E734B8D70E87", "stratification"=>"95DF97E7-810D-48A5-8F02-99FA4B384A7B"}
• CMS155v1/0024 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents: HQFM_ID: 8A4D92B2-397A-48D2-0139-7CC6B5B8011E Stratification ID 5722134D-5F7C-42AD-914B-E73B4C366D55
  • Could not find entry for measure 8A4D92B2-397A-48D2-0139-7CC6B5B8011E with the following population ids {"IPP"=>"E83A6DA6-D34E-4107-8431-2FB2C86738C7", "DENOM"=>"A08E22DD-9B31-40AD-BA5C-5DB43F8FFBE4", "NUMER"=>"E3ACA22F-9239-417D-8074-E4882FB0F848", "DENEX"=>"FE61FF42-F9EF-4ADA-9D3F-E734B8D70E87", "stratification"=>"5722134D-5F7C-42AD-914B-E73B4C366D55"}
  • Could not find entry for measure 8A4D92B2-397A-48D2-0139-7CC6B5B8011E with the following population ids {"IPP"=>"E83A6DA6-D34E-4107-8431-2FB2C86738C7", "DENOM"=>"A08E22DD-9B31-40AD-BA5C-5DB43F8FFBE4", "NUMER"=>"84C557E8-41B1-43F6-8C1B-1D204335AAFB", "DENEX"=>"FE61FF42-F9EF-4ADA-9D3F-E734B8D70E87", "stratification"=>"5722134D-5F7C-42AD-914B-E73B4C366D55"}

Thus a system that, in accordance with the spec, omits these unnecessary Reporting Stratum templates will not pass certification.

When the Reporting Stratum templates are added to the document, the errors go away.

This issue potentially affects any measure with reporting strata.

Affected EH measures:

• CMS32
• CMS55
• CMS111

Affected EP measures:

• CMS74
• CMS126
• CMS137
• CMS153
• CMS155