CMS EHR Header Errors and Edits

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2013 CMS Data Submission Specifications Errors and Edits for Header Section
This document provides errors and edits pertinent to the header section of
the QRDA files. For these errors and edits to work properly, it is assumed
that the QRDA files are VALID CDA release 2 files.

Introduction

04/25/2012

1 of 15

2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 16 rows
Header Attributes
Error
Reference to CMS QRDA
Code
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

Action

10001CONF-QRDA1-1

ClinicalDocument/realmCode

realmCode element is missing

The 'realmCode' element SHALL be
present.

Required

Error

10002CONF-QRDA1-1

ClinicalDocument/realmCode/@code

realmCode 'code' value SHALL be 'US'

Required

Error

10006CONF-QRDA1-3

ClinicalDocument/templateId

templateId element is missing

Required

Error

10007CONF-QRDA1-4

ClinicalDocument/templateId/@root

QRDA Category templateId 'root' value
SHALL be '2.16.840.1.113883.10.20.12'
and PQRI QRDA category I templateId
'root' value SHALL be
'2.16.840.1.113883.3.249.11.100.1'.

The realmCode 'code' attribute value
SHALL be 'US'.
The 'templateId' element SHALL be
present.
QRDA Category templateId 'root' value
SHALL be '2.16.840.1.113883.10.20.12'
and PQRI QRDA category I templateId
'root' value SHALL be
'2.16.840.1.113883.3.249.11.100.1'.

Required

Error

10011CONF-QRDA1-7

ClinicalDocument/code/@code

code 'code' value SHALL be '55182-0'

Error

10012CONF-QRDA1-7

ClinicalDocument/code/@codeSystem

10013CONF-QRDA1-8

ClinicalDocument/title

code 'codeSystem' value SHALL be
'2.16.840.1.113883.6.1'
title is missing

10014CONF-QRDA1-8

ClinicalDocument/title

10016CONF-QRDA1-10

ClinicalDocument/effectiveTime/@value

The code 'code' attribute value SHALL be Required
'55182-0'.
Required
The code 'codeSystem' attribute value
SHALL be '2.16.840.1.113883.6.1'.
Required
The 'title' element SHALL be submitted
exactly once.
The 'title' element SHALL either be “Quality Required
Measure Report” or “QRDA Incidence
Report”.
Required
The effectiveTime 'value' attribute value
SHALL be at least precise to the day
(YYYYMMDD).

10017CONF-QRDA1-10

ClinicalDocument/effectiveTime/@value

Required

Error

10019CONF-QRDA1-12

ClinicalDocument/confidentialityCode/@code

Required

Error

10020CONF-QRDA1-12

ClinicalDocument/confidentialityCode/@codeSystem

Required

Error

10021CONF-QRDA1-13

ClinicalDocument/setId

setId element is missing

effectiveTime 'value' length SHALL be at
least 8 characters.
The confidentialityCode 'code' attribute
value SHALL be 'N'.
The confidentialityCode 'codeSystem'
attribute value SHALL be
'2.16.840.1.113883.5.25'.
The 'setId' element SHALL be present.

Required

Error

10022CONF-QRDA1-16

ClinicalDocument/versionNumber

versionNumber element is missing

The 'versionNumber' element SHALL be
present.

Required

Error

10027CONF-QRDA1-5

ClinicalDocument/cda:id[@root][@extension]

id/ @extension and id/ @root element
SHALL be present.

id/ @extension and id/ @root element
SHALL be present.

Required

Error

10028CONF-QRDA1-13

ClinicalDocument/cda:setid[@root][@extension]

setid/ @extension and id/ @root element
SHALL be present.

setid/ @extension and id/ @root element
SHALL be present.

Required

Error

Header_Attributes

title value SHALL either be “QRDA
Incidence Report” or “Quality Measure
Report” (case-insensitive)
effectiveTime 'value' SHALL be at least
precise to the day (YYYYMMDD)
effectiveTime 'value' length SHALL be at
least 8 characters.
confidentialityCode 'code' value SHALL be
'N'
confidentialityCode 'codeSystem' value
SHALL be '2.16.840.1.113883.5.25'

04/25/2012

Error
Error
Error
Error

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 34 rows
Participants Record Target
Error Reference to CMS QRDA Data
CMS QRDA Data Element
Code
Submission Spec
ClinicalDocument/recordTarget/patientRole/
10103CONF-QRDA1-22
patient

Validation Criteria
patientRole 'patient' element is missing

Report Error Message
The 'patient' element SHALL be submitted
exactly once.

Optionality

Action

Required

Error

10104CONF-QRDA1-23

ClinicalDocument/recordTarget/patientRole/
patient/name

patient's legal 'name' element is expected at least once The patient's legal 'name' element SHALL be
submitted at least once.

Required

Error

10105CONF-QRDA1-24

ClinicalDocument/recordTarget/patientRole/
patient/name/given
ClinicalDocument/recordTarget/patientRole/
patient/name/family

patient's legal name 'given' (first name) element is
expected at least once
patient's legal name 'family' (last name) element is
expected at least once

Required

Error

Required

Error

ClinicalDocument/recordTarget/patientRole/
patient/ethnicGroupCode
ClinicalDocument/recordTarget/patientRole/
patient/ethnicGroupCode/@codeSystem

patient 'ethnicGroupCode' element is missing

10107CONF-QRDA1-25

10109CONF-QRDA1-26
10110CONF-QRDA1-26
10111CONF-QRDA1-26

ClinicalDocument/recordTarget/patientRole/
patient/ethnicGroupCode/@code

10112CONF-QRDA1-27

ClinicalDocument/recordTarget/patientRole/
patient/administrativeGenderCode
ClinicalDocument/recordTarget/patientRole/
patient/administrativeGenderCode/
@codeSystem
ClinicalDocument/recordTarget/patientRole/
patient/administrativeGenderCode/@code

10113CONF-QRDA1-27
10114CONF-QRDA1-27

10115CONF-QRDA1-28
10116CONF-QRDA1-28
10117CONF-QRDA1-28

10118CONF-QRDA1-29
10119CONF-QRDA1-30
10120CONF-QRDA1-31

10121CONF-QRDA1-32
10122CONF-QRDA1-32
10123CONF-QRDA1-32

Participants_Record_Target

ClinicalDocument/recordTarget/patientRole/
patient/raceCode
ClinicalDocument/recordTarget/patientRole/
patient/raceCode/@codeSystem
ClinicalDocument/recordTarget/patientRole/
patient/raceCode/@code
ClinicalDocument/recordTarget/patientRole/
patient/birthTime
ClinicalDocument/recordTarget/patientRole/
patient/birthTime
ClinicalDocument/recordTarget/patientRole/
providerOrganization
ClinicalDocument/recordTarget/patientRole/
providerOrganization/id
ClinicalDocument/recordTarget/patientRole/
providerOrganization/id/@root
ClinicalDocument/recordTarget/patientRole/
providerOrganization/id/@extension

The patient's legal 'given' (first name) element
SHALL be submitted at least once.
The patient's legal 'family' (last name) element
SHALL be submitted at least once.

The 'ethnicGroupCode' element SHOULD be
Optional
present.
patient ethnicGroupCode 'codeSystem' value SHALL The patient's ethnic group code 'codeSystem' Conditional
be '2.16.840.1.113883.5.50'
attribute value SHALL be
'2.16.840.1.113883.5.50'.
patient ethnicGroupCode 'code' value SHALL be valid The patient's ethnic group 'code' value SHALL Conditional
be valid according to Appendix_AB-Ethnicity in
the posted Downloadable Resource table.
patient administrativeGenderCode element is missing The 'administrativeGenderCode' element
Required
SHALL be present.
patient administrativeGenderCode 'codeSystem' value The patient's administrative gender code
Required
SHALL be '2.16.840.1.113883.5.1'
'codeSystem' attribute value SHALL be
'2.16.840.1.113883.5.1'.
patient administrativeGenderCode 'code' value SHALL The patient's administrative gender 'code' value Required
be valid
SHALL be valid according to Appendix_ACGender in the posted Downloadable Resource
table.

Warning

patient 'raceCode' element is missing

The 'raceCode' element SHOULD be present.

Warning

raceCode 'codeSystem' value SHALL be
'2.16.840.1.113883.5.104'
patient raceCode 'code' value SHALL be valid

The patient's race code 'codeSystem' attribute Conditional
value SHALL be '2.16.840.1.113883.5.104'.
The patient's race 'code' attribute value SHALL Conditional
be valid according to Appendix_AD-Race in the
posted Downloadable Resource table.

Error

birthTime is missing

The 'birthTime' element SHALL be present.

Required

Error

birthTime SHALL be at least precise to the day
(YYYYMMDD)
patientRole 'providerOrganization' element is missing

The 'birthTime' element SHALL be at least
precise to the day (YYYYMMDD).
The patient's 'providerOrganization' SHALL be
submitted exactly once.

Required

Error

Required

Error

The 'providerOrganization/id' element SHALL be Required
present.
providerOrganization id 'root' value SHALL be
The id 'root' attribute value SHALL be
Required
'2.16.840.1.113883.4.6'
'2.16.840.1.113883.4.6'.
providerOrganization id 'extension' value SHALL be
The patient's provider organization's id
Required
present and contain the NPI of the provider (expect 10- 'extension' attribute value SHALL be present as
byte numeric value in XXXXXXXXXX format; no
the provider's NPI (expect 10-byte numeric
special characters or letters; value must not contain
value in XXXXXXXXXX format; no special
1234 as the first four consecutive digits; 10th digit of
characters or letters; value must not contain
value must pass NPI check digit validation algorithm) 1234 as the first four consecutive digits; 10th
digit of value must pass NPI check digit
validation algorithm).

Error

providerOrganization 'id' element is missing

04/25/2012

Optional

Error
Error
Error
Error
Error

Error

Error
Error

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

Error Reference to CMS QRDA Data
CMS QRDA Data Element
Code
Submission Spec
ClinicalDocument/recordTarget/patientRole/
10124CONF-QRDA1-33
providerOrganization/name
ClinicalDocument/recordTarget/patientRole/
10125CONF-QRDA1-34
providerOrganization/addr
ClinicalDocument/recordTarget/patientRole/
10126CONF-QRDA1-37
providerOrganization/addr/state
ClinicalDocument/recordTarget/patientRole/
10127CONF-QRDA1-37
providerOrganization/addr/state

Validation Criteria

Optionality

Action

Optional

Warning

providerOrganization 'addr' element is missing

The provider organization's 'name' element
SHOULD be present.
The 'addr' element SHALL be present.

Required

Error

providerOrganization addr 'state' element is missing

The 'state' element SHALL be present.

Required

Error

providerOrganization addr 'state' element SHALL be
valid according to Appendix_AK-States in the posted
Downloadable Resource table.

The patient's provider organization's 'state'
element SHALL be valid according to
Appendix_AK-States in the posted
Downloadable Resource table.

Required

Error

providerOrganization 'name' element is missing

Report Error Message

10128CONF-QRDA1-39

ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf

providerOrganization 'asOrganizationPartOf' element is The 'asOrganizationPartOf' element SHALL be Required
missing
allowed exactly once.

Error

10129CONF-QRDA1-40

ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf/
wholeOrganization
ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf/
wholeOrganization/id
ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf/
wholeOrganization/id/@root
ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf/
wholeOrganization/id/@extension

asOrganizationPartOf 'wholeOrganization' element is
missing

The 'wholeOrganization' element SHALL be
allowed exactly once.

Required

Error

wholeOrganization 'id' element is missing

The 'wholeOrganization/id' element SHALL be
present.

Required

Error

wholeOrganization id 'root' value SHALL be
'2.16.840.1.113883.4.2'

The id 'root' attribute value SHALL be
'2.16.840.1.113883.4.2'

Required

Error

wholeOrganization id 'extension' value SHALL be
present and contain a TIN for the provider's
organization (expect to be a nine-digit value in
XXXXXXXXX format)

The patient's provider's organization's id
Required
'extension' attribute value SHALL be present as
the provider's TIN (nine-digit value in
XXXXXXXXX format).

Error

10133CONF-QRDA1-19

cda:ClinicalDocument/cda:recordTarget/
cda:patientRole/cda:id[@root][@extension

id/ @root and id/ @extension element SHALL be
present.

id/ @root and id/ @extension element SHALL
be present.

Required

Error

10134CONF-QRDA1-20

cda:ClinicalDocument/cda:recordTarget/
cda:patientRole/cda:id[@root][@extension]

id/ @root and id/ @extension element SHALL be
present exactly once.

Error

10135CONF-QRDA1-32

cda:ClinicalDocument/cda:recordTarget/
cda:patientRole/cda:providerOrganization/
cda:id@root and id/@extension

10136CONF-QRDA1-41

cda:ClinicalDocument/cda:recordTarget/
cda:patientRole/cda:providerOrganization/
cda:asOrganizationPartOf/
cda:wholeOrganization/cda:id[@root]
[@extension]

The 'recordTarget/patientRole/id@root and
Required
id/@extension' element SHALL be submitted
exactly once.
The
The
Required
'recordTarget/patientRole/providerOrganization/id@roo 'recordTarget/patientRole/providerOrganization/i
t and id/@extension' element missing or SHALL be
d@root and id/@extension' element SHALL be
submitted exactly once.
submitted exactly once.
The
The
Required
'recordTarget/patientRole/providerOrganization/asOrga 'recordTarget/patientRole/providerOrganization/
nization/asOrganizationPartOf/wholeOrganization/
asOrganization/asOrganizationPartOf/
id@root and id/@extension' element SHALL be
wholeOrganization/id@root and id/@extension'
submitted exactly once.
element SHALL be submitted exactly once.

10137CONF-QRDA1-41.1

ClinicalDocument/recordTarget/patientRole/
providerOrganization/telecom

Warning

10138CONF-QRDA1-41.2

ClinicalDocument/recordTarget/patientRole/
providerOrganization/asOrganizationPartOf/
wholeOrganization/telecom

The report SHOULD contain exactly one
The report SHOULD contain exactly one
Optional
recordTarget/patientRole/providerOrganization/telecom recordTarget/patientRole/providerOrganization/t
elecom.
The report SHOULD contain exactly one
The report SHOULD contain exactly one
Optional
recordTarget/patientRole/providerOrganization/asOrga recordTarget/patientRole/providerOrganization/
nizationPartOf/wholeOrganization/telecom
asOrganizationPartOf/wholeOrganization/
telecom.

10130CONF-QRDA1-41
10131CONF-QRDA1-41
10132CONF-QRDA1-41

Participants_Record_Target

04/25/2012

Error

Error

Warning

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 4 rows
Participants Author
Error
Reference to CMS QRDA
Code
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

The 'author' element SHALL
be submitted exactly once.

Action

10201CONF-QRDA1-42

ClinicalDocument/author

author element is expected exactly once

Required

Error

10203CONF-QRDA1-44

ClinicalDocument/author/time

Error

10218CONF-QRDA1-46

ClinicalDocument/author/assignedAuthor/id/@root

time element SHALL be at least precise to the The 'time' element SHALL be Required
at least precise to the day
day (YYYYMMDD)
(YYYYMMDD).
assigned/Author id 'root' SHALL be
The assigned/Author id 'root' Required
2.16.840.1.113883.3.249.6
SHALL be
2.16.840.1.113883.3.249.6.

10219CONF-QRDA1-46

ClinicalDocument/author/assignedAuthor/id/
@extension

assignedAuthor id 'extension' SHALL be valid The @extension value SHALL Required
represent CMS Approved
Qualified EHR Software
Version.

Error

Participants_Author

04/25/2012

Error

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 5 rows
Participants Informant
Error
Reference to CMS QRDA Data
Code
Submission Spec

CMS QRDA Data Element

10301CONF-QRDA1-56

ClinicalDocument/informant

10304CONF-QRDA1-59

ClinicalDocument/informant/
assignedEntity/id @NullFlavor

10305CONF-QRDA1-60

ClinicalDocument/informant/
assignedEntity/
representedOrganization
ClinicalDocument/informant/
assignedEntity/
representedOrganization/id
ClinicalDocument/informant/
assignedEntity/
representedOrganization/name

10306CONF-QRDA1-61
10307CONF-QRDA1-62

Particpants_Informant

Validation Criteria

Report Error Message

Optionality

Action

informant element is
The 'informant' element SHALL be
expected exactly once
submitted exactly once.
where informant
If assignedEntity 'id' root value is
assignedEntity 'id' root value missing and not applicable, then id
is missing and not
'NullFlavor' value SHALL be 'NA'.
applicable, then id
'NullFlavor' value SHALL be
'NA'.

Required

Error

Conditional

Error

assignedEntity's
'representedOrganization'
element is missing
representedOrganization's
'id' element is missing

The 'representedOrganization'
element SHALL be present.

Required

Error

The 'representedOrganization/id'
element SHALL be present.

Required

Error

The informant's
informant's
representedOrganization's representedOrganization's 'name'
'name' element SHOULD be element SHOULD be present.
present

Optional

Warning

04/25/2012

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 2 rows
Participants Custodian
Error
Reference to CMS QRDA
Code
Data Submission Spec
10401CONF-QRDA1-64

10403CONF-QRDA1-65

Participants_Custodian

CMS QRDA Data Element

Validation Criteria

custodian/assignedCustodian/
representedCustodianOrganization/id

Report Error Message

The
The
representedCustodianOrganization's representedCustodianOrganization's
'id' element SHALL be submitted
'id' element SHALL be submitted
exactly once.
exactly once.
custodian/assignedCustodian/
representedCustodianOrganization's The 'name' element SHOULD be
representedCustodianOrganization/name 'name' element SHOULD be present present.

04/25/2012

Optionality

Action

Required

Error

Optional

Warning

7 of 15

2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 11 rows
Participants Legal Authenticator
Error
Reference to CMS QRDA
Code
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

Action

legalAuthenticator element SHOULD be The 'legalAuthenticator' element
present
SHOULD be present.
where legalAuthenticator 'time' element If the 'legalAuthenticator' element is
is present, it SHALL be at least precise to present, the legalAuthenticator 'time'
the day (YYYYMMDD)
element SHALL be at least precise to
the day (YYYYMMDD).

Optional

Warning

Conditional

Error

Conditional

Error

If the 'legalAuthenticator' element is
Conditional
present, the assignedEntity 'id' element
SHALL be submitted exactly once.

Error

10501CONF-QRDA1-66

ClinicalDocument/legalAuthenticator

10504CONF-QRDA1-68

ClinicalDocument/legalAuthenticator/time

10506CONF-QRDA1-70

ClinicalDocument/legalAuthenticator/
signatureCode/@code

where 'legalAuthenticator' element is
If the 'legalAuthenticator' element is
present, signatureCode 'code' value must present, the legalAuthenticator's
be 'S'
signatureCode 'code' attribute value
SHALL be 'S'.

10508CONF-QRDA1-72

ClinicalDocument/
legalAuthenticator/assignedEntity/id

where 'legalAuthenticator' element is
present, assignedEntity 'id' element is
expected exactly once

10509CONF-QRDA1-73

ClinicalDocument/
where 'legalAuthenticator' element is
If the 'legalAuthenticator' element is
Optional
legalAuthenticator/assignedEntity/assignedPer present, assignedEntity 'assignedPerson' present, the legalAuthenticator's
son
element SHOULD be present
'assignedPerson' element SHOULD be
present.

Warning

10510CONF-QRDA1-74

ClinicalDocument/
where 'legalAuthenticator' element is
legalAuthenticator/assignedEntity/assignedPer present, assignedPerson's 'name'
son/name
element SHOULD be present

Warning

10511CONF-QRDA1-74

ClinicalDocument/
where 'legalAuthenticator' element is
legalAuthenticator/assignedEntity/assignedPer present, assignedPerson's 'name'
son/name
element is expected exactly once

If the legalAuthenticator
Conditional
'assignedPerson' element is present,
the assignedPerson's 'name' element
SHOULD be present.
If the legalAuthenticator's
Conditional
assignedPerson's 'name' element is
present, the 'name' element SHALL be
submitted exactly once.

10516CONF-QRDA1-76

ClinicalDocument/
where 'legalAuthenticator' element is
legalAuthenticator/assignedEntity/represented present, assignedEntity
Organization
'representedOrganization' element
SHOULD be present

If the 'legalAuthenticator' element is
present, the legalAuthenticator's
'representedOrganization' element
SHOULD be present.

Optional

Warning

10518CONF-QRDA1-77

ClinicalDocument/
where legalAuthenticator's
If the legalAuthenticator's
legalAuthenticator/assignedEntity/represented assignedEntity 'representedOrganization' assignedEntity
Organization/id
element is present, the
'representedOrganization' element is
representedOrganization's 'id' element is present, the legalAuthenticator's
expected exactly once
representedOrganization 'id' element
SHALL be submitted exactly once.

Conditional

Error

10519CONF-QRDA1-78

ClinicalDocument/
where legalAuthenticator's
If the legalAuthenticator's
legalAuthenticator/assignedEntity/represented assignedEntity 'representedOrganization' assignedEntity
Organization/name
element is present, the
'representedOrganization' element is
representedOrganization's 'name'
present, the legalAuthenticator's
element SHOULD be present
representedOrganization's 'name'
element SHOULD be present.

Optional

Warning

Participants_Legal_Auth

04/25/2012

Error

8 of 15

2013 CMS Data Submission Specifications Errors and Edits for Header Section

Error
Code

Reference to CMS QRDA
Data Submission Spec

10520CONF-QRDA1-78

Participants_Legal_Auth

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

ClinicalDocument/
where legalAuthenticator's
If the legalAuthenticator's
Conditional
legalAuthenticator/assignedEntity/represented representedOrganization's 'name'
representedOrganization's 'name'
Organization/name
element is present, it is expected exactly element is present, the 'name' element
once
SHALL be submitted exactly once.

04/25/2012

Action
Error

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 11 rows
Participants Primary Care Provider
Error
Reference to CMS QRDA
Code
Data Submission Spec

CMS QRDA Data Element

10601CONF-QRDA1-79
10602CONF-QRDA1-79

ClinicalDocument/participant
ClinicalDocument/participant/@typeCode

10603CONF-QRDA1-80

ClinicalDocument/participant/fuctionCode

10604CONF-QRDA1-81

ClinicalDocument/participant/functionCode/
@code
ClinicalDocument/participant/functionCode/
@codeSystem

10605CONF-QRDA1-82
10607CONF-QRDA1-84

ClinicalDocument/participant/
associatedEntity/@classCode

10608CONF-QRDA1-85

cda:ClinicalDocument/cda:participant/
cda:associatedEntity/cda:id[@root]

10609CONF-QRDA1-85

ClinicalDocument/participant/
associatedEntity/id
ClinicalDocument/participant/
associatedEntity/associatedPerson

10610CONF-QRDA1-86
10611CONF-QRDA1-88

ClinicalDocument/participant/
associatedEntity/associatedPerson/name

10616CONF-QRDA1-85

ClinicalDocument/participant/
associatedEntity/id/@root

Participants_Primary_Care_Prov

Validation Criteria

Report Error Message

Optionality

Action

participant element missing
The 'participant' element SHALL be present.
Required
participant 'typeCode' value SHALL be The participant 'typeCode' attribute value SHALL Required
'PRF'
be 'PRF'.
participant 'functionCode' element
The 'participant/functionCode' element SHALL be Required
missing
present.
participant functionCode 'code' value The functionCode 'code' attribute value SHALL Required
SHALL be 'PCP'
be 'PCP' (primary care physician).
Required
participant functionCode 'codeSystem' The functionCode 'codeSystem' attribute value
SHALL be '2.16.840.1.113883.5.88'.
attribute value SHALL be
'2.16.840.1.113883.5.88'
Required
participant associatedEntity
The participant associatedEntity 'classCode'
'classCode' attribute value SHALL be attribute value SHALL be 'PROV' (healthcare
'PROV'
provider).
participant associatedEntity 'id'
Required id or id/ @root element SHALL be
Required
element is missing
present.

Error
Error

Required
The participant associatedEntity 'id' element
SHALL be submitted exactly once.
The participant associatedEntity
Optional
'associatedPerson' element SHOULD be present.

Error

If the participant associatedEntity
'associatedPerson' element is present, the
associatedPerson's 'name' element SHALL be
submitted exactly once.

Error

participant associatedEntity 'id'
element is expected exactly once
participant associatedEntity
'associatedPerson' element SHOULD
be present
where participant associatedPerson's
'name' element is present, it is
expected exactly once

Conditional

participant associatedEntity 'id/@root' participant associatedEntity 'id/@root' SHALL be Required
element is missing
present.

04/25/2012

Error
Error
Error
Error
Error

Warning

Error

10 of 15

2013 CMS Data Submission Specifications Errors and Edits for Header Section

This is a table with 7 columns and 25 rows
Relationships Documentation of
Error
Reference to CMS QRDA
Code
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message
The 'documentationOf' element
SHALL be present.

Optionality

Action

11001CONF-QRDA1-89

ClinicalDocument/documentationOf

documentationOf element is missing

Required

Error

11003CONF-QRDA1-91

ClinicalDocument/documentationOf/
serviceEvent/code
ClinicalDocument/documentationOf/
serviceEvent/code

serviceEvent 'code' element is expected The serviceEvent 'code' element
Required
exactly once
SHALL be submitted exactly once.
serviceEvent 'code' value SHALL be
The serviceEvent 'code' value SHALL Required
valid according to Appendix_Bbe valid according to Appendix_BEncounters of the Downloadable
Encounters of the posted
Resource table
Downloadable Resource table for the
current program year.

Error

11005CONF-QRDA1-92

ClinicalDocument/documentationOf/
serviceEvent/effectiveTime

serviceEvent 'effectiveTime' element is The serviceEvent 'effectiveTime'
Required
expected exactly once
element SHALL be submitted exactly
once.

Error

11006CONF-QRDA1-93

ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low

serviceEvent 'effectiveTime' SHALL
contain exactly one low value element

Required

Error

11007CONF-QRDA1-93

ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low
ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high

effectiveTime low value length SHALL effectiveTime low value length SHALL Required
be at least 8 characters.
be at least 8 characters.
serviceEvent 'effectiveTime' SHALL
The serviceEvent effectiveTime 'high Required
contain exactly one high value element value' (end date of the encounter)
elements SHALL be present.
effectiveTime high value length SHALL effectiveTime high value length SHALL Required
be at least 8 characters.
be at least 8 characters.
serviceEvent 'effectiveTime' (low value) The serviceEvent 'effectiveTime' (start Required
element SHALL be prior to or equal to date) element SHALL be prior to or the
the serviceEvent 'effectiveTime' (high same as the serviceEvent
value)
'effectiveTime' (end date).

Error

11004CONF-QRDA1-91

11008CONF-QRDA1-93
11009CONF-QRDA1-93
11010CONF-QRDA1-93

ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high
ClinicalDocument/documentationOf/
serviceEvent/effectiveTime

The serviceEvent effectiveTime 'low
value' (start date of the encounter)
elements SHALL be present.

Error

Error
Error
Error

11011CONF-QRDA1-93

ClinicalDocument/documentationOf/
serviceEvent/effectiveTime

serviceEvent 'effectiveTime' (low value The serviceEvent 'effectiveTime' (start Required
and high value) elements SHALL be at date and end date) elements SHALL
least precise to the day (YYYYMMDD) be at least precise to the day
(YYYYMMDD).

Error

11015CONF-QRDA1-96

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/id

serviceEvent performer's
assignedEntity 'id' element is present
more than once

The performer's 'assignedEntity/id'
Required
value SHALL be present exactly once.

Error

11016CONF-QRDA1-97

ClinicalDocument/documentationOf/
serviceEvent performer's
The id 'root' attribute value SHALL be Required
serviceEvent/performer/assignedEntity/id@root assignedEntity id 'root' value SHALL be '2.16.840.1.113883.4.6'.
'2.16.840.1.113883.4.6'

Error

Relationships_Documentation_of

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Error
Code

Reference to CMS QRDA
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

Action

11017CONF-QRDA1-97

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/
id@extension

serviceEvent performer's
The serviceEvent performer's
Required
assignedEntity id 'extension' value
assignedEntity id 'extension' attribute
SHALL be present and contain the NPI value SHALL be present as the
of the provider (expect 10-byte numeric provider's NPI (expect 10-byte numeric
value in XXXXXXXXXX format; no
value in XXXXXXXXXX format; no
special characters or letters; value must special characters or letters; value
not contain 1234 as the first four
must not contain 1234 as the first four
consecutive digits; 10th digit of value
consecutive digits; 10th digit of value
must pass NPI check digit validation
must pass NPI check digit validation
algorithm)
algorithm).

Error

11019CONF-QRDA1-98

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/code

serviceEvent performer's
assignedEntity 'code' is missing

Conditional

Error

11020CONF-QRDA1-99

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr

serviceEvent performer's
The serviceEvent performer's
assignedEntity 'addr' (address) element assignedEntity 'addr' (address)
is missing
element SHOULD be present.

Optional

Warning

11021CONF-QRDA1-99

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr

where serviceEvent performer's
assignedEntity 'addr' (address) is
present, it is expected exactly once

If the serviceEvent performer's
assignedEntity 'addr' (address)
element is present, it SHALL be
submitted exactly once.

Conditional

Error

11022CONF-QRDA1-100

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
streetAddressLine

where serviceEvent performer's
assignedEntity 'addr' (address) is
present, 'streetAddressLine' element is
missing

If the serviceEvent performer's
Conditional
assignedEntity 'addr' (address)
element is present, the
'streetAddressLine' element SHOULD
be present.

Warning

11023CONF-QRDA1-100

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
streetAddressLine

If the serviceEvent performer's
assignedEntity 'streetAddressLine'
element is present, it SHALL be
submitted exactly once.
If the serviceEvent performer's
assignedEntity 'addr' (address)
element is present, the 'city' element
SHOULD be present.

Conditional

Error

Conditional

Warning

11024CONF-QRDA1-101

where serviceEvent performer's
assignedEntity 'streetAddressLine'
element is present, it is expected
exactly once
ClinicalDocument/documentationOf/
where serviceEvent performer's
serviceEvent/performer/assignedEntity/addr/city assignedEntity 'addr' (address) is
present, 'city' element is missing

The serviceEvent performer's
assignedEntity 'code' SHALL be
present.

11025CONF-QRDA1-101

ClinicalDocument/documentationOf/
where serviceEvent performer's
If the serviceEvent performer's
Conditional
serviceEvent/performer/assignedEntity/addr/city assignedEntity 'city' element is present, assignedEntity 'city' element is
it is expected exactly once
present, it SHALL be submitted exactly
once.

Error

11026CONF-QRDA1-102

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
state

Warning

Relationships_Documentation_of

where serviceEvent performer's
assignedEntity 'addr' (address) is
present, 'state' element is missing

04/25/2012

If the serviceEvent performer's
Conditional
assignedEntity 'addr' (address)
element is present, the 'state' element
SHOULD be present.

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2013 CMS Data Submission Specifications Errors and Edits for Header Section

Error
Code

Reference to CMS QRDA
Data Submission Spec

CMS QRDA Data Element

Validation Criteria

Report Error Message

Optionality

Action

11027CONF-QRDA1-102

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
state

where serviceEvent performer's
If the serviceEvent performer's
Conditional
assignedEntity 'state' element is
assignedEntity 'state' element is
present, it is expected exactly once and present, it SHALL be submitted exactly
be valid according to Appendix_AKonce and be valid according to
States in the posted Downloadable
Appendix_AK-States in the posted
Resource table.
Downloadable Resource table.

Error

11028CONF-QRDA1-103

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
postalcode

Warning

11029CONF-QRDA1-103

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/addr/
postalcode

where serviceEvent performer's
If the serviceEvent performer's
Conditional
assignedEntity 'addr' (address) is
assignedEntity 'addr' (address)
present, 'postalcode' element is missing element is present, the 'postalcode'
element SHOULD be present.
where serviceEvent performer's
If the serviceEvent performer's
Conditional
assignedEntity 'postalcode' element is assignedEntity 'postalcode' element is
present, it is expected exactly once
present, it SHALL be submitted exactly
once.

Relationships_Documentation_of

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Error

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Error
Code

Reference to CMS QRDA
Data Submission Spec

11031CONF-QRDA1-104

Relationships_Documentation_of

CMS QRDA Data Element

Validation Criteria

Report Error Message

ClinicalDocument/documentationOf/
serviceEvent/performer/assignedEntity/
assignedPerson

where serviceEvent performer's
assignedEntity 'assignedPerson'
element is present, it is expected
exactly once

If the serviceEvent performer's
assignedEntity 'assignedPerson'
element is present, it SHALL be
submitted exactly once.

04/25/2012

Optionality
Conditional

Action
Error

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This is a table with 7 columns and 4 rows
Common Errors
CMS QRDA Data Element
Error
Reference to CMS QRDA
Code
Data Submission Spec
(Relatio
10700
nships

Validation Criteria

Report Error Message

Optionality

Action

The CMS EHR QRDA Report SHALL
conform to the CDA R2 standard.
10701
[XPATH] value SHALL not exceed the
maximum allowable length [LENGTH].
10702
File is submitted after the submission
deadline for the submission period

The submission deadline for the
program initiative has passed. Files
are no longer being accepted.

10703
A System error has occurred while
processing your file. Please contact
the QualityNet Help Desk for more
information.

Common_Errors

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