Below is the clarification provided by the PQRS team: ****** In the past (prior to the 2015 reporting period), for clinical 'results', PQRS has required that, if the xsi:type="PQ" then a numeric value must be provided, otherwise, if the xsi;type is anything other than "PQ", then a valid 'coded' value (i.e. code/codeSystem/valueSet) must be provided. However, in many cases an eCQM measure definition tests for the timing of clinical result but does not care what the actual result value is. Because of this revelation, PQRS has modified its validation for clinical 'results'. It is still the case that if the xsi:type="PQ" then a numeric value must be provided, but now, a clinical 'results' is determined to be a 'coded' result if, and only if, the xsi:type is "CD", "CE", "CO", or "CV". If the xsi:type is anything other than "PQ", "CD", "CE", "CO", or "CV", then no validation occurs on whatever result has been provided. These changes only pertain to clinical 'results' which are limited to the 'value' elements associated with the following constraints: • CONF:16695 - Diagnostic Study Result • CONF:16697 - Laboratory Test Result • CONF:16699 - Physical Exam Finding • CONF:16701 - Procedure Result • CONF:14450 - Risk Category Assessment ****** For this particular use case raised in this ticket, to summarize, because the eCQM specification does not specify a result attribute for Risk Category Assessment (and therefore no value set is specified for the result attribute), it is the expected behavior of SEVT to submit a nullFlavor using the ST data type for value. If a coded result (e.g., CD data type) were submitted, SEVT validates the code/code system/valueSet combination, code must be a valid code specified in the value set (value set OID provided in @sdtc:valueSet).