Hi Mohammad,

The screen shot for the 2020 sample file is an example for Medication Not Administered (notice that negationInd is true), so you use sdtc:valueSet to provide the value set OID from what's specified in eCQM to indicate that none of the medications from that value set was given. 

Examples for templates in QRDA I STU 5.1 volume 2 are to show positive QDM data elements (not negated, negationInd is not set to true), so a specific code from the value set is provided. 

Hello yanheras, Thank you for the response.

We see that there is a misalignment between QRDA HL7 IG and Sample files provided for CY 2019 and 2020 Reporting. Also the Cypress validator was not throwing error while validating QRDA files for the above mentioned issue for CY 2019 Reporting. Please find below the screenshots of HL7 IG(CDAR2_IG_QRDA_I_R1_STU_R5.1_2018DEC_Vol2_2019OCT_with_errata) and sample file from the recent QRDA 1 update for CY 2020 reporting for your perusal. Thank you.

HL7 IG (CDAR2_IG_QRDA_I_R1_STU_R5.1_2018DEC_Vol2_2019OCT_with_errata):

Sample file for CY 2020 Reporting:

Yes, it is mandatory to use <code nullFlavor="NA" stdc:valueSet="......."/> to report negated QDM data elements providing the value set OID that is specified in eCQM specifications. 

The only exception is that if the negation logic in an eCQM specification references a direct referenced code instead of a value set, then you will use the  <code code="..." displayName="...." codeSystem="....." codeSystemName="....."/> to provide the direct referenced code. 

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