The QRDA Category I Schematron rules in Cypress 2.1.0 incorrectly flag a warning when the documentationOf section contains two or more performer elements that contain an NPI.

The follow fragment represents two providers, each with an NPI:

<documentationOf>
    <serviceEvent classCode="PCPR">
        <effectiveTime>
            <low value="20130411" />
        </effectiveTime>
        <performer typeCode="PRF">
            <assignedEntity>
                <id root="2.16.840.1.113883.4.6" extension="111" />
                <representedOrganization />
            </assignedEntity>
        </performer>
        <performer typeCode="PRF">
            <assignedEntity>
                <id root="2.16.840.1.113883.4.6" extension="222" />
                <representedOrganization />
            </assignedEntity>
        </performer>
    </serviceEvent>
</documentationOf>

Given a QRDA Category I file that contains such a fragment, Cypress reports the following warning:

This assignedEntity id/@root coupled with the id/@extension represents the individual provider's National Provider Identification number (NPI). This assignedEntity SHALL contain exactly one [1..1] id (CONF:16587) such that it SHOULD contain zero or one [0..1] @root="2.16.840.1.113883.4.6" National Provider ID (CONF:16588).

Here is the corresponding rule from the QRDA.sch file:

count(cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity[count(cda:id[@root='2.16.840.1.113883.4.6'])=1]) < 2

Translation: There is at most one assignedEntity element that contains exactly one NPI.

Clearly that rule is violated whenever more than one provider is specified (each containing an NPI). It also fails to detect the case where multiple NPIs are specified for the same provider.

The following test more closely meets the intent of the conformance statement:

count(cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity[count(cda:id[@root='2.16.840.1.113883.4.6']) > 1]) = 0

Translation: There are no assignedEntity elements that contain more than one NPI.