Table of Contents:
Purpose:
The difference between Error & Warning Messages
Data Accuracy / Source Viewer Messages for Data Edits and Schematron Rules
Data Accuracy / Source Viewer Error & Warning Messages
Schematron Error & Warning Messages
Purpose:
Below are The Joint Commission specific error and warning messages generated by the edits and Schematron rules executed against each uploaded QRDA I Document. In addition, those CMS and Health Level Seven (HL7) Schematron rules that are frequently encountered when data is uploaded to the DDS Platform are also included below.
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QRDA I documents that generate one or more error messages have been rejected and not processed against the eCQM logic. They are available for you to view within the Source Viewer from the Data Accuracy page. Since they have not been processed against the eCQM logic, they are not available on the Quality Improvement page and cannot be submitted via the Submit Data page.
QRDA I documents that generated one or more warning messages AND no error messages may be submitted. We recommend that hospitals review the warning messages to ensure they are not pointing to issues with data capture, data mapping, or QRDA I file generation that can be corrected before the submission deadline. However, we do realize that hospitals may not have the ability to regenerate QRDA I documents from prior years and so they are unable to correct these warning messages. If this is your situation, we suggest you continue to review the warning messages and, if needed, work to update your software for the next calendar year and for future years so as to eliminate these warning messages to ensure your measure rates are as accurate as possible.
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For more information concerning CMS or HL7 Conformance numbers, see the below reference material:
CMS: Visit For the documents associated with this year’s data, visit the eCQI Resource Center CMS QRDA IG publication page for the documents associated to this year's data, or copy and paste the following web address in your internet browser: https://ecqi.healthit.gov/qrda-quality-reporting-document-architecture.
HL7: Visit the For the documents applicable for this year’s data, visit the HL7 website to obtain the version of the HL7 CDA® R2 IG: QRDA I applicable for this year's data, or copy and paste the following web address in your internet browser: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=35.
The HL7 website may require a HL7 account in order to download the Implementation Guide (IG).
The HL7 website header states the current Release number. Scroll to the bottom of the page to find the Release that is appropriate for this calendar years data.
See the eCQM Version Alignment with CMS documentation for information concerning the version of measures, CMS QRDA IG, and HL7 standards that are applicable to this year's data.
Data Accuracy / Source Viewer Error Messages
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Table is in order by Message # |
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to find specific numerical or text strings in the table below, i.e.
“Control” + “F” for Windows
”Command-F” for
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Message # | Section/ Element | Status | Data Accuracy Label
(Short Description) | Source Viewer Description
(Long Description) | Expected Behavior in Source Viewer Upon Clicking Error | |
100001 | Discharge Date | Critical | | | | |
100002 | Discharge Date | Critical | | | | |
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100004 | Discharge Date | Critical | | | | |
100005 | Discharge Date | Critical | | | | |
100006 | Admit Date | Critical | | | | |
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100007 | Admit Date | Critical | | | | |
100008 | DateTime | Critical | Invalid DateTime | Invalid DateTime has been provided. (TJC-100008) | Highlight the template/EffectiveTime with incorrect date | |
For 2021, add validation: |
100009 | Admit Date | Critical | | | | |
100010 | Admit Date | Critical | | | | |
100012 | DateTime | Warning | Invalid DateTime | Invalid DateTime has been provided. (TJC-100012) | Highlight the template/EffectiveTime with incorrect date | |
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100022 | Discharge Date | Critical | No Discharge Date in Reporting Period | CMS Program Name is an Inpatient Program (HQR_PI, HQR_IQR, HQR_PI_IQR) and there is NO Inpatient Discharge Date within the reporting period defined in the Reporting Parameters section in the QRDA file. (TJC-100022) | Highlight the first Inpatient Encounter | When CMS Program Name is an Inpatient Program (HQR_PI, HQR_IQR, HQR_PI_IQR)
Anything on or before 23:59:59 local time on the final day of the reporting period is valid.
Do not apply offset before validation |
100023 | High@value | Critical | Event start date after the end date | Event End date is before the Event Start Date. (TJC-100023) | Highlight the template/EffectiveTime with incorrect date | Rejection for all dates in TJC xPath Document required by current eCQMs. |
apply offset before validation |
100024 | High@value | Warning | Event start date after the end date | Event End date is before the Event Start Date. (TJC-100024) | Highlight the template/EffectiveTime with incorrect date | Warning for all dates in TJC xPath Document but not used by current eCQMs. |
apply offset before validation |
100025 | Encounter ID | Warning | Inconsistent reporting of Inpatient Encounter | CMS Program Name is an Inpatient Program and
there exists inconsistent encounter id, code/codeSystem or effectiveTime in the Inpatient Encounter templates for the same episode, there is a possibility of increased number of EOCs. (TJC-100025) | Highlight the first instance of Inpatient Encounter template for the same episode | For CMS Program Name is an Inpatient Program (HQR_PI, HQR_IQR, HQR_PI_IQR)
When two inpatient encounters exist, if below condition, we consider they are the same encounter: |
*admit and discharge dates are the same |
*encounter IDs and extension are the same |
If the same inpatient encounters are reported, we only allow for valueset to be different, everything else should be the same. If any below condition, we trigger this edit: |
1. Admit, discharge date or their offsets are different
2. Encounter ID or extension is different
3. encounter code/codeSystem is different |
Apply offset before comparison |
100026 | Encounter ID | Warning | Duplicate Inpatient Encounter Detected | | Highlight the first instance of Inpatient Encounter template for the same episode | For CMS Program Name is an Inpatient Program (HQR_PI, HQR_IQR, HQR_PI_IQR)
Admit and discharge dates, encounter code and encounter ID (root and extension) are the same among duplicates. |
Apply offset |
100027 | Patient id | Critical | Invalid QRDA XML file
| | Source Viewer stays blank with no data | Any character which engine is not able to process will trigger this error
(& and foreign numbers and characters are invalid chars).
Following characters are valid for patient_id:
English alphabet and numeric characters, and following special characters:
~ ! @ # $ % ^ * ( ) _ + { } | : ? ` - = [ ] \ ; ‘ . , / < > and space |
100029 | Patient id | Critical | Invalid Patient ID | Invalid Patient ID has been provided. (TJC-100029)
| Expectation: Highlight the Patient ID | The patient-id fields cannot be greater than 100 characters OR there are invalid characters. |
100031 | XML File | Critical | Invalid QRDA XML file | | Source Viewer stays blank with no data | File is not a valid QRDA XML file |
100032 | CCN | Critical | Incorrect CCN Reported | The CCN does not match with the CCN associated to the current HCO. (TJC-100032) | Highlight the CCN Number | The CCN is provided. However, the CCN in the document does not match with the CCN associated to the current user.
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100035 | | Critical | | Invalid or null US Realm Date and Time is provided. (TJC-100035) | | |
Note: Do not use the template id to find the date, Following the XPath should be sufficient to find the effective time |
Do not apply offset before validation |
100036 | Encounter ID
| Warning | Inpatient encounter outside of the reporting quarter | CMS Program Name is an inpatient Program and there exists an inpatient encounter with discharge datetime outside of the reporting quarter defined in the Reporting Parameter of the QRDA document. (TJC-100036) | Highlight the Encounter ID | For CMS Program Name is an Inpatient Program (HQR_PI, HQR_IQR, HQR_PI_IQR)
This warning will only trigger when at least one of the inpatient encounter's discharge datetime is outside of the reporting quarter.
Do not apply offset |
100037 | Route Code | Warning | A required Medication Route is missing | Route code is missing for an administered medication, and is required by a reported eCQM. (TJC-100037) | Highlight the Medication Template, which is missing the route, AND has negationInd=false or it's negationInd missing AND the code belongs to the value set required by eCQM | Only trigger the warning for those Medications that belong to the value set that eCQM asks for, AND do not have the route and are not negated with negationID=true. (e.g. VTE-1 and VTE-2) |
Below listed are Value sets and Codes that need Route code |
1. Unfractionated Heparin value set (2.16.840.1.113883.3.117.1.7.1.218) contains the following codes: |
(1361607, 1658717, 1659195, 1659197) |
2. Low Dose Unfractionated Heparin for VTE Prophylaxis (2.16.840.1.113762.1.4.1045.39 ) value set contains the following codes : |
(1361226, 1361568, 1361574, 1361577, 1361615, 1361853, 1362831, 1658634, 1658637, 1658647, 1658659, 1659260, 1659263, 1798389, 2121591) |
RouteCode ValueSets and codes
A) ["Medication, Administered": "*Low Dose Unfractionated Heparin for VTE Prophylaxis*"] VTEMedication
where VTEMedication.route in "Subcutaneous route":
"Subcutaneous route" valueset 2.16.840.1.113883.3.117.1.7.1.223 and code in this value set- 34206005 |
B) Medication, Administered": "Unfractionated Heparin"] UnfractionatedHeparin
where UnfractionatedHeparin.route in "Intravenous route"
"Intravenous route" valueset 2.16.840.1.113883.3.117.1.7.1.222and codes in this value set- 418114005, 419993007, 47625008 |
100039 | Result Unit | Warning | Unacceptable Unit Reported | There exists an unacceptable unit in the QRDA document. Enter the correct unit as definied in the eCQM logic to avoid an unexpected outcome. (TJC-100039)
| Highlight the incorrect/invalid unit | Validate this edit only when below conditions are met- |
1. When below specified measures are reported |
2. When code is in the below listed Value Sets |
3. When result value is provided |
Note: DO NOT trigger warning if code is provided from below listed Value Sets but reported measure is not from below specified measures. |
List of measures, required units and data element/Value Sets: |
For eSTK-6 - unit 'mg/dL' for Laboratory Test Performed
"Laboratory Test, Performed: LDL-c" using "LDL-c (2.16.840..1138833.117.1.7.1.215)"for For ePC-05 and ePC-06- code "Gestational age--at birth" ("LOINC Code (76516-4)") |
valueset "Birth Weight" (2.16.840.1.113762.1.4.1029.194) |
100041 | | Critical | No outpatient measure reported |
In the QRDA document, reported CMS program name is 'HQR_OQR'. QRDA file did not report any CMS Program Name is "HQR_OQR", but there is no TJC supported outpatient measure reported in file. (TJC-100041) | Highlight the CMS program name | This edit triggers when QRDA file contains CMS program name as 'HQR_OQR' but no TJC supported outpatient measures are reported. |
100042 | | Critical | No inpatient measure reported |
In the QRDA document, reported CMS program name is 'CMS Program Name is an Inpatient Program (HQR_PI |
' OR ''' OR ''. QRDA file did not report any ), but there is no TJC supported inpatient measure reported in file. (TJC- 100042) | Highlight the CMS program name | This edit triggers when QRDA file contains CMS program name as 'HQR_ |
PI' OR ''HQR_IQR' OR 'HQR_PI_IQR but OQR' but no TJC supported |
inpatient outpatient measures are reported. |
100043 | | Warning | Inpatient measure reported for outpatient CMS program name |
TJC supported Inpatient measures will not be evaluated when reported CMS program name is 'HQR_OQR' . (TJC- 100043) | Highlight the CMS program name | This warning will only trigger when |
*CMS program name as 'HQR_OQR ' |
*QRDA file contains TJC supported outpatient measures |
*And at least one of the TJC supported |
inpatient inpatient measures |
100044 | | Warning | Outpatient measure reported for inpatient CMS program name |
TJC supported outpatient Outpatient measures will not be evaluated when reported CMS program name as ' HQR_PI' OR ''HQR_IQR' OR 'HQR_PI_IQR ' . (TJC- 100044)
| Highlight the CMS program name | This warning will only trigger when |
*CMS program name as 'HQR_PI' OR ''HQR_IQR' OR 'HQR_PI_IQR ' |
*QRDA file contains TJC supported Inpatient measures |
*And at least one of the TJC supported |
outpatient outpatient measures |
100045 | Departure Date | Critical | No ED Relevant Period High Date in Reporting Period | CMS Program Name is 'HQR_OQR' and there is NO ED Relevant Period High Date (effectiveTime/ high) within the reporting period defined in the Reporting Parameters section in the QRDA file. (TJC-100045) | Highlight the first Departure Encounter | When CMS Program Name is an outpatient Program (HQR_OQR)
Anything on or bef
Anything on or before 23:59:59 local time on the final day of the reporting period is valid.
Do not apply offset before validation |
100046 | Encounter ID | Warning | Inconsistent reporting of Outpatient Encounter | CMS Program Name is an Outpatient Program and
there exists inconsistent encounter id, code/codeSystem or effectiveTime in the Outpatient Encounter templates for the same episode, there is a possibility of increased number of EOCs. (TJC-100046) | Highlight the first instance of Outpatient Encounter template for the same episode | For CMS Program Name is an Outpatient Program (HQR_OQR)
When two outpatient encounters exist, if below condition, we consider they are the same encounter: |
*Relevant Period Low Date and Relevant Period High Dates are the same |
*encounter IDs and extension are the same |
If the same outpatient encounters are reported, we only allow for valueset to be different, everything else should be the same. If any below condition, we trigger this edit: |
1. Relevant Period Low Date and Relevant Period High Date or their offsets are different |
2. Encounter ID or extension is different |
3. encounter code/codeSystem is different |
Apply offset before comparison |
100047 | Encounter ID | Warning | Duplicate Outpatient Encounter Detected | | Highlight the first instance of Outpatient Encounter template for the same episode | For CMS Program Name is an Outpatient Program (HQR_OQR)
Relevant Period Low Date and Relevant Period High Date, encounter code and encounter ID (root and extension) are the same among duplicates. |
Apply offset |
100048 | Encounter ID
| Warning | Outpatient encounter outside of the reporting quarter | CMS Program Name is an Outpatient Program and there exists an outpatient encounter Relevant Period High Date outside of the reporting quarter defined in the Reporting Parameter of the QRDA document. (TJC-100048) | Highlight the Outpatient Encounter ID | For CMS Program Name is an Outpatient Program (HQR_OQR)
This warning will only trigger when at least one of the outpatient encounter Relevant Period High Date is outside of the reporting quarter.
Do not apply offset |
Schematron Error Messages
Message # | Section / Element | Status | Data Accuracy Label(Short Description) | Source Viewer Description (Long Description) | Expected Behavior in Source Viewer Upon Clicking Error | |
CMS_0121 | Time Zone | Critical | r-validate_TZ-errors | A Coordinated Universal Time (UTC time) offset should not be used anywhere in a QRDA Category I file or, if a UTC time offset is needed anywhere, then it must be specified everywhere a time field is provided (CONF: CMS_0121) | Highlights the date time field that has the inconsistent UTC time offset | Validate time zone offset for all datetime fields in the QRDA I file. |
TJC_0121 | Time Zone | Critical | r-validate_TZ-errors | A Coordinated Universal Time (UTC time) offset should not be used anywhere in a QRDA Category I file or, if a UTC time offset is needed anywhere, then it must be specified everywhere a time field is provided (CONF: TJC_0121) | Highlights the date time field that has the inconsistent UTC time offset for an Observation result that is a datetime | Validate time zone offset for all datetime fields in the QRDA I file. |
TJC-0007 | Reporting Parameter | Critical | Reporting-Parameters-Act-TJC-errors | This effectiveTime SHALL contain exactly one [1..1] low and exactly one [1..1] high for reporting period start date and end date respectively. Reporting Period must only represent one calendar quarter with valid start and end dates of the quarter (TJC-0007). | Highlights Reporting Parameter section containing invalid start date and end date | Validates the start and end date of Reporting Period in a given QRDA I file |
TJC-0011 | CCN | Critical | QDM_based_QRDA_TJC-errors | CCN (Facility CMS Certification Number), if present, SHALL be six to ten characters in length (TJC-0011). | | Validate CCN in a given QRDA I file. |
TJC-0036 | effectiveTime and Time | Warning | r-validate_effectiveTime-TJC-warnings | effectiveTime or time SHALL have either @value or low and high but SHALL NOT have @value and low and high. (TJC-0036) | Highlight the effectiveTime or Time attribute within a template that contains both @value and @low and/or @high | Validates the effectiveTime/Time attribute of all the data elements in a given QRDA I file |
TJC-0048 | Document Level templateID | Warning | | This document SHALL contain exactly one [1..1] US Realm document level templateId @root="2.16.840.1.113883.10.20.22.1.1" @extension="2015-08-01". CDA data elements will not be validated properly (TJC-0048). | | |
TJC-0049 | Document Level templateID | Warning | | This document SHALL contain exactly one [1..1] QRDA Category I Framework document level templateId @root="2.16.840.1.113883.10.20.24.1.1" @extension="2017-08-01". QRDA-I data elements will not be validated properly (TJC-0049). | | |
TJC-0050 | Document Level templateID | Warning | | This document SHALL contain exactly one [1..1] QDM-based QRDA document level templateId @root="2.16.840.1.113883.10.20.24.1.2" @extension="2021-08-01". QDM data elements will not be validated properly (TJC-0050) | | |
TJC-0051 | Date Time Elements | Critical | r-validate_TZ-errors | A Coordinated Universal Time (UTC time) offset should not be used anywhere in a QRDA Category I file or, if a UTC time offset is needed anywhere, then it must be specified everywhere a time field is provided (CONF: TJC_0051) | Highlights the date time field that has the inconsistent UTC time offset | |
TJC-0052 | Race | Warning | r-validate_race-TJC-warnings-abstract | You have provided a raceCode that was not found in ValueSet Race urn:oid:2.16.840.1.114222.4.11.836. (TJC-0052) | Highlights the patient section containing the an invalid raceCode | Validates the code in the raceCode template in the patient section in a given QRDA I file |
TJC-0053 | Ethnicity | Warning | r-validate_ethnicity-TJC-warnings-abstract | You have provided a ethnicGroupCode that was not found in ValueSet Ethnicity urn:oid:2.16.840.1.114222.4.11.837. (TJC-0053) | Highlights the patient section containing the an invalid ethnicGroupCode | Validates the code in the ethnicGroupCode template in the patient section in a given QRDA I file |
TJC-0054 | Gender | Warning | r-validate_gender-TJC-warnings-abstract | You have provided a administrativeGenderCode that was not found in ValueSet ONC Administrative Sex urn:oid:2.16.840.1.113762.1.4.1. (TJC-0054) | Highlights the patient section containing the an invalid administrativeGenderCode | Validates the code in the administrativeGenderCode template in the patient section in a given QRDA I file |