The attached QRDA document (QA data, not PII) is calculating as a Denominator Exception due to the presence of a negated discharge medication from the “Antithrombotic Therapy" value set (2.16.840.1.113762.1.4.1110.62).   The negation rationale is SNOMED-CT 105480006, “Procedure declined by patient”, from the Patient Refusal value set (2.16.840.1.113883.3.117.1.7.1.93).  The author date/time of the medication is 20220525103000.

The episode of care encounter is SNOMED-CT 32485007 with a relevant period of 20220525100000 - 20220528130000

The discharge medication is within the timing window, author date/time during encounter relevant period, to be used in the expression definition “Encounter With No Antithrombotic At Discharge”.   

The file passes the Cypress Validation Utility with no errors.  The patient, we transcribed to Bonnie, correctly calculates as a denominator exception.   We cannot find any errors in the format of the QRDA document that would cause this patient to not be considered a denominator exception.  Can you please take a look at HQR and let us know what the issue is?