There are a set of assertions at the front of the 2016 ESAC Schematron rules that result in undocumented and unnumbered error messages being display when the assertion fails.

Here is the list of problem messages...

• Data types of CD or CE SHALL have either @code or @nullFlavor or both (@codeSystem and @nullFlavor="OTH") but SHALL NOT have both @code and @nullFlavor and SHALL NOT have @codeSystem and @nullFlavor not equal to "OTH" (Rule: validate_CD_CE)
• Data types of BL SHALL have either @value or @nullFlavor but SHALL NOT have both @value and @nullFlavor (Rule: validate_BL)
• Data types of CS SHALL have either @code or @nullFlavor but SHALL NOT have both @code and @nullFlavor (Rule: validate_CS)
• Data types of II SHALL have either @root or @nullFlavor or (@root and @nullFlavor) or (@root and @extension) but SHALL NOT have all three of (@root and @extension and @nullFlavor) (Rule: validate_II)
• Data types of PQ SHALL have either @value or @nullFlavor but SHALL NOT have both @value and @nullFlavor. If @value is present then @unit SHALL be present but @unit SHALL NOT be present if @value is not present. (Rule: validate_PQ)
• Data types of ST SHALL either not be empty or have @nullFlavor. (Rule: validate_ST)
• Data types of REAL SHALL NOT have both @value and @nullFlavor. (Rule: validate_REAL)
• Data types of INT SHALL NOT have both @value and @nullFlavor. (Rule: validate_INT)
• The NPI should have a correct checksum, using the Luhn algorithm. (Rule: p-validate_NPI_format)
• When a Tax Identification Number is used, the provided TIN must be in valid format (9 decimal digits). (Rule: validate_TIN_format)
• Data types of TS SHALL have either @value or @nullFlavor but SHALL NOT have @value and @nullFlavor. (Rule: validate_TS)
• The document must contain the document level template [templateId with root='2.16.840.1.113883.10.20.24.1.3' and extension='2015-07-01'] for this schematron to be applicable.

In most cases, these error messages just need to be documented in the 2016 CMS QRDA SIG. Also, unless there is some valid reason for not doing so, these restriction should have CONF numbers associated with them. However, in one case, (i.e. the template ID 2.16.840.1.113883.10.20.24.1.3 test) there is not need for this message at all. This constraint is already defined as the CMS_0001,CMS_0002, CMS_0003 'such that' constraint. This error message should be deleted and the CMS error message should be used in its place.