CMS QRDA / eCQM Quality Reporting
CMS_QRDAfree10 data-quality rules for CMS electronic clinical quality measure (eCQM) reporting via QRDA (Quality Reporting Document Architecture) Category I and III. Covers required QRDA header elements, CMS measure identifiers, VSAC value-set conformance, measure population logic (numerator within denominator), reporting-period validity, and performance-rate bounds. Use it to validate a QRDA submission before sending to CMS (Promoting Interoperability / MIPS).
Checks included (10)
Required QRDA Header Elements Present
Each QRDA report must carry the patient/aggregate id, reporting period, measure section, and program/measure-set identifiers.
Patient Identifier Present (QRDA I)(patient_id)
Category I (patient-level) reports must carry a patient identifier on every record.
Payer Supplemental Data Present(payer_code)
CMS requires the Payer supplemental data element on quality reports.
Measure ID Is a Valid CMS eCQM
The reported eCQM measure identifier must exist in the CMS eCQM measure set for the reporting year.
Clinical Codes Conform to VSAC Value Sets
Coded clinical data referenced by the measure (LOINC, SNOMED CT, RxNorm) must be members of the measure's VSAC value sets.
Numerator Is Within the Denominator
For each measure, the numerator population count cannot exceed the denominator. A numerator larger than the denominator is invalid measure logic.
Reporting Period Start Before End
The measurement period start must not be after its end.
One Record per Patient per Measure(patient_measure_key)
A patient should appear once per measure in a Category I file; duplicates double-count populations.
Administrative Gender Is Valid(administrative_gender)
Administrative gender must be a valid AdministrativeGender code (M, F, UN).
Performance Rate Between 0 and 1 (QRDA III)(performance_rate)
Category III aggregate performance rates must fall between 0 and 1 inclusive.