Encounter.reasonCode is not recognized

[RohitKandimalla]

Summary

For the attached MeasureBundle and TestCaseBundle, looks like highlighting is not as expected.

ValidEncounter.reasonCode is not recognized even though the attached TestCaseBundle has Encounter resource with reasonCode

I double checked and Chronic recurrent major depressive disorder (disorder) - 2618002 is a valid code in Major Depressive Disorder Active Please Advice

External Tracking Ticket

BONNIEMAT-1567

Expected Behavior

Expecting the Encounter.ReasonCode to be identified and used for execution.

Version or Commit

Inputs (e.g. Measure Bundle, Patient Bundle, CQL Library)

CMS161FHIR-v0.0.004-DENOMPass-DxDuringEncOV.txt

MeasureBundle.txt

Relevant Calculation Options (e.g. Measurement Period, meta.profile Validation)

cql-to-elm Version Used for Measure Logic Translation (if known)

v2.11.0

Any Additional Info

[AngelaFlanagan]

A similar issue seems to be impacting CMS 2, CMS 22, CMS 69, CMS 347, and CMS 506 although these measure display with reasonCode in blue but not the alias and seems to impact more than reasonCode but similarly .notDoneReason, reasonRefused, notDoneReason, and doNotPerform. Please advise if another ticket should be created and if MADiE packages should be uploaded here. An attachment with screen shots of the lack of highlighting and the logic present in the json test. Thank you in advance for your assistance, Angela Flanagan, Lantana Consulting Multiple Measures Unable to Reach 100% Coverage Since MADiE 1.1.10 Release.docx

[elsaperelli]

Hi @RohitKandimalla, thank you for submitting this issue. Our investigation thus far has us believing that this is not a problem with the test data, but rather the highlighting and coverage calculation. It looks like the lack of highlighting on ValidEncounter.reasonCode is due to a specific ELM annotation situation that we need to provide a workaround for. We have created a task for this issue and are currently investigating it.

Hi @AngelaFlanagan, thank you for the detailed document! Unfortunately, it looks like while some of these highlighting issues may be related, they seem slightly different so we will need to investigate this as well. Would it be possible to get the CMS2 and CMS69 measures so our team can investigate these further?

[AngelaFlanagan]

Elsa, Please find attached the MADiE exports for measures CMS 2 and CMS 69. We appreciate your assistance. Thank you, CMS69FHIR-v0.1.000-FHIR4.zip CMS2FHIR-v0.1.000-FHIR4.zip

[hossenlopp]

Hi @AngelaFlanagan. Would it be possible to get the test case exports as well for these two measures?

With CMS506, I don't think the doNotPerform is a highlighting issue since you showed test data that has that field set to false. A result of false for a clause will not satisfy highlighting or coverage, a "truthy" value is needed to be marked as highlighted/covered. If you create a testCase with doNotPerform set to true, it should highlight and count as covered.

[AngelaFlanagan]

Hello, Please find the test case exports for CMS 2 and CMS 69. Thank you. CMS2FHIR-v0.1.000-FHIR4-TestCases.zip CMS69FHIR-v0.1.000-FHIR4-TestCases.zip

[hossenlopp]

Thank you so much for the quick response @AngelaFlanagan, this will help us with debugging and resolving these issues.

[AngelaFlanagan]

Chris, The resource MedicationRequest is fixed to false so unable to test, please see attached snapshot and advise. Thank you, Angela CMS 506 doNotPerform.docx

[hossenlopp]

@AngelaFlanagan I see. But that brings the question, if it is fixed to false, then why does that check need to be in the logic?

[hossenlopp]

For clarification, the issue in CMS506 is not related to the Encounter.reasonCode and notDoneReason highlighting issues. If further discussion is needed on this it should probably happen in a different forum.

[AngelaFlanagan]

Chris, Authoring patterns (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1#encounters) recommended the addition of doNotPerform is not true prior to this becoming a fixed value, so I will remove the logic. Thank you, Angela

[kimberlysmuk]

Hi All - Going back to the initial question - Encounter.reasonCode is not recognized as it pertains to 161, 177, 996 - can someone provide an update or next steps?

[hossenlopp]

Hi @kimberlysmuk,

We are in the process of wrapping up and publishing fixes to cql-execution and fqm-execution that will fix highlighting and clause coverage percentage calculation for Encounter.reasonCode. This was a two part issue:

• In cql-execution there was a minor bug that was preventing the recording of results for individual clauses in a few places. This was why reasonCode was not highlighting and not counting in coverage. The fix makes no changes to actual results of measure calculation. It just makes sure the results are recorded for more clauses.
• In fqm-execution there needed to be a special case added to handle the quirky QICore ELM for Encounter.reasonCode. This attribute is a list of CodeableConcept and requires the translator to inject extra logic. This injected logic needs some special handling to be properly highlighted in coverage highlighting.

We plan to publish new versions of these packages this afternoon or tomorrow morning. After these are published SB will be able to pull them into their next MADiE release.

[kimberlysmuk]

Awesome - appreciate your review and thank you for summarizing so concisely.

[hossenlopp]

Resolved in v1.3.0.

[hossenlopp]

@AngelaFlanagan, we have closed this ticket since we have resolved the initial topic. Some of the issues you brought forth were related and you may see them resolved in your measures once this new fqm-execution version is released in MADiE. After the release, if you still have additional issues, please submit them to the BONNIEMAT ONC Jira tracker.