I was doing Cypress C1 testing in Cypress V 5.4.1 and I was having failures in below scenarios:

For CMS9 C1 was failing saying "procedure, performed not complete". Patient data had Parenteral Nutrition given whose timings were not during the Inpatient Encounter visit so that the patient qualifies for the Initial Population criteria. We do not write procedure into the QRDA file because it is false evidence for the criteria.

For CMS71 C1 was failing saying "medication, discharge not complete". Patient data criteria required discharge disposition of expired as well as medication discharge with negation rationale along with other criteria's. Since discharge disposition was given, the patient qualified for Denominator Exclusions. Our evaluator engine does not evaluate the Denominator Exceptions as exclusions is true. Medication Discharge with negation being a Denominator Exceptions criteria hence will not be written into the QRDA Category I file.

My question for CMS 9: Is it necessary to capture Procedure because if it satisfies the Encounter timings, the patient is not in Initial population and no QRDA file is generated. Writing it into the QRDA 1 file is just like additional evidence which does not make much difference in calculation.

My question for CMS 71: Since the patient is qualifying for Exclusions and not for exceptions, we do not write the medication discharge into the QRDA 1 file, but why is C1 test expecting it to be present.

Thanks,
Auryl