The Cypress Validation Utility measure outcome calculator has been extremely helpful; however, capturing negations does not align with QualityNet. HL7 QRDA R3 introduces the ability to document value sets without codes for negations. We have leveraged this ability in such a way that a hospital organization can now say that "Aspirin Ingredient Specific" was not prescribed at discharge without having to select an RxNorm code. A specific negation reason is still sent via SNOMED RSON code.

I have attached a file for an AMI-2 patient who is in the Denominator when evaluating with the CVU but is in the denominator exception when submitted to QualityNet. My guess is that CVU tries to validate the code is in the sdtc:valueset.

Adjusting the CVU for this issue would help with alignment with CMS submission and give hospital organizations more confidence in validating measure status outcomes with the CVU.