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QRDA-I Standard
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Resolution: No Further Action by OD's
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Minor
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None
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Files will be rejected (with xsd error) if they do not contain at least one "id" for assignedEntity but the IGs do not require the element.
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CMS/DECC-HQR
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Estelle Noone
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410-872-7830
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Guidance provided in the comments from an email from Yan Heras
Inconsistent validation for CONF:2228-16587 in QRDA-I xsd and schematron
CMS 2017 HQR IG:
a. [HQR] This assignedEntity SHOULD contain zero or one [0..1] id (CONF:2228-16587) such that it
i. [HQR] SHALL contain exactly one [1..1] @root="2.16.840.1.113883.4.6" National Provider ID (CONF:2228-16588).
The Schematron rule conforms to the IG rule:
<sch:rule id="QDM_based_QRDA_V3-documentationOf-serviceEvent-performer-assignedEntity-warnings" context="cda:ClinicalDocument[cda:templateId[@root='2.16.840.1.113883.10.20.24.1.2'][@extension='2016-02-01']]/cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity">
<sch:assert id="a-2228-16587-warning" test="count(cda:id[@root='2.16.840.1.113883.4.6'])=1">This assignedEntity SHOULD contain zero or one [0..1] id (CONF:2228-16587) such that it SHALL contain exactly one [1..1] @root="2.16.840.1.113883.4.6" National Provider ID (CONF:2228-16588).</sch:assert>
However, the xsd requires that there be one or more ids:
<xs:complexType name="POCD_MT000040.AssignedEntity">
<xs:sequence>
…
<xs:element name="id" type="II" maxOccurs="unbounded"/>
…
My understanding is that if only a value for the maxOccurs attribute is specified, it must be greater than or equal to the default value of minOccurs, i.e., 1 or more – thus “id” is required.
Such a file without an “id” supplied for assignedEntity, would fail the CDA xsd check, and be rejected. Whereas the guidance in the CMS (and HL7) IG show “id” as a SHOULD, so validation would treat it as a warning and not reject the file.