Hi oracles,

Does this solution answer your question?

If you have no further follow up questions, this ticket will be considered resolved and closed on Friday, October 25.

Thank you.

If you provide a reason for not done, then it has to provide a medical or patient reason code from the value sets defined by the measures as observation/value to the Reason template. This is specified in the HL7 QRDA I IG. The attached is a screenshot of the Reason (V3) template, it says: SHALL contain exactly one [1..1] value with @xsi:type="CD" (CONF:3343-11367). 

Regarding whether code value for 73832-8 is mandatory or not, since this is using the Assessment Performed template, the value element is optional per the HL7 QRDA I IG. MAY contain zero or one [0..1] value (CONF:4509-29121). 

Note that if the measure specification asks for Assessment Performed result in its logics, then value needs to be provided to avoid leading to unexpected measure outcomes. Since the denominator exception measure logics do not ask for result, then value is optional in this case.  

Is there any update regarding this team? yanheras 

Thank you for submitting a ticket to the QRDA JIRA Issue Tracker. Our experts are reviewing your ticket and will provide feedback as soon as possible. Thank you for your patience.

Thank you for submitting a ticket to the QRDA JIRA Issue Tracker. Our experts are reviewing your ticket and will provide feedback as soon as possible. Thank you for your patience.

Yes, it's necessary to require either a medical or patient reason for not done to qualify for denominator exception. It's represented using a fixed code(73832-8 and 77301-0)and an OID value (code system - 2.16.840.1.113883.6.1) and the code system name (LIONC as  attached in the screenshot). 

Are you mentioning this code (73832-8 and 77301-0) as Reason template?

Our question : Is the code value (73832-8 / 77301-0 / any other denominator exception reason code) is mandatory in QRDA file?

I am not sure if I followed your questions exactly. I think you are asking whether it is required to include the Reason template (the reason for negation), which has a fixed LOINC code 77301-0 for observation/code. 

Using your example, "Assessment, Not Performed", the Assessment Performed template in QRDA I states that "QDM attribute: Negation Rationale is represented by setting negationInd="true" and stating the reason (rationale) in a contained Reason (V3) template."  This is driven by the QDM specification. QDM-based eCQMs are specified to require either a medical or patient reason for not done to qualify for denominator exception. 

If you do not include the Reason template to provide the reason for not done for this particular case, the QRDA I file may pass validation, but when the data is evaluated against denominator exception logic, it would fail measure logics such as this and may lead to unexpected measure outcome. 
where ( NoAdultScreen.negationRationale ~ "Depression screening declined (situation)"
or NoAdultScreen.negationRationale in "Medical Reason"
)
 

If I miss understood your questions, please let us know. Further clarifications would be helpful.