We are using HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I), Release 1, STU Release 5 - US Realm to identify, sdtc:valueset should be printed for which data element and when for negation templates.

As per VOL 1 Page 25, when the QDM elements are defined with value sets, negation templates will follow same approach as QRDA Category I release (e.g., STU R4) and should be printed using code nullFlavour and sdtc:valueset as shown below:

<code nullFlavor="NA" sdtc:valueSet="some value">

In the Cypress test patient for CMS138, I am seeing 39240-7 LOINC code listed for the negation template despite of having Value Sets listed for the criteria. Please clarify if this is a bug in Cypress? Is it ok to not to print null flavour and print the code directly for all the negation templates regardless of the "direct reference code" or "QDM Elemetns with valueset" concept ?

See attached referenced file for CMS138 -> Assessment Performed Not Done template.