We are preparing for eCQM measure certification for which we are using Cypress 4.0.4 patient list for testing and validation purposes.

For CMS145, eCQM measure specs QDM Category is looking for Valueset OID along with Null Flavor for the Medication Not Ordered template.

"Medication, Not Ordered: Beta Blocker Therapy for LVSD" using "Beta Blocker Therapy for LVSD (2.16.840.1.113883.3.526.3.1184)"
"Medication, Not Ordered: Beta Blocker Therapy" using "Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1174)"

On Cypress test deck Patient Gary Maldonado is documented with RxNORM code 854901 belonging to valueset oid "2.16.840.1.113883.3.526.3.1184" and "2.16.840.1.113883.3.526.3.1174". Since CMS specs is providing Value Set OID and not the single code belonging to Valueset OID /direct reference code, our system is simply coded look for Value Set OID for negation template for this criteria.

Could you please confirm if this is a valid patient? We are expecting patient documented with one of the Value Set OID and not the code belonging to Value Set OID.

Also, We confirmed with yanheras at the beginning of the year (she is a consultant for our organization) as below:

*Question asked: *

1) Can we print the appropriate code (same as direct reference code concept) in place of nullflavour and sdtc:valueset for the QDM Elements defined with value sets for the negation templates?

*Ans from Yan: *

No, if the eCQM specification measure logics for medication not ordered references a value set, then you must provide the value set OID. If you provide a code from the value set instead, this will be ignored by the receiving system’s measure engine, such as The Joint Commission’s.