I am creating this ticket as a follow-up to the issue we previously raised regarding CMS22v13 logic. While the previous ticket CYPRESS-2745 has been closed, we need few clarifications on expected behavior for negative test scenario.
 
As per last comment ticket: CYPRESS-2745 : In the QRDA file negates the entire valueset "2.16.840.1.113762.1.4.1108.125" which includes codes 183617005, 183618000, 183619008, 183620002, 183621003, 183622005, 183623000 which are also in the valueset "2.16.840.1.113883.3.526.3.1578".
 
We have conditioned a patient Ifera, Igor such that:
1. There is no prior hypertensive reading within 1 year, disqualifying the patient from entering the denominator exception path.
2. "Intervention, Not Ordered: Follow Up Within 6 Months" code 300042001 present only in valueset OID (2.16.840.1.113762.1.4.1108.125)" is not present in the shared value set for the 4-week follow-up OID "2.16.840.1.113883.3.526.3.1578"
3. Patient Ifera, Igor does not have those specific shared codes.
Despite this, Cypress is still assigning the denominator exception credit.
 
We have attached the QRDA1 file for your review, and we would appreciate your help understanding:
        • How Cypress interprets the follow-up declined observation in relation to the value set logic.
        • If there’s a specific way to structure the QRDA to prevent unintentional exception credit being applied.
Looking forward to your insights. We are aiming to confirm that our negative test cases are being interpreted correctly by Cypress and align with the CMS22v13 logic as intended.
 
Please let us know if any more information needed from our side.