c-cda/uscdi-v3 Error for the SDOH Assessment under the Social history section

[sridevi Brijesh]

Hi,

I am getting this error for the SDOH Assessment under the Social history section. Please review and let us know.

Result Description: The scenario does not require Comparing Assessment Scale Observation data for code 88121-9 , Assessment Value Comparison : data, but submitted file does have Comparing Assessment Scale Observation data for code 88121-9 , Assessment Value Comparison : data

Result Description: The scenario contains Assessment Scale Supporting Observaton data with code 88122-7 , however there is no matching data in the submitted CCDA.

Result Description: The scenario contains Assessment Scale Supporting Observaton data with code 88123-5 , however there is no matching data in the submitted CCDA.

<entry>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.38"/>
<templateId root="2.16.840.1.113883.10.20.22.4.38" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.38" extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code nullFlavor="NA">
<originalText>
<reference value="#_8024db4c-8bcc-4bbc-987f-efc0f7c1252c"/>
</originalText>
<translation nullFlavor="NI"/>
</code>
<text>
<reference value="#_c9396164-f522-43c9-a298-0c96e0e6517e"/>
</text>
<statusCode code="completed"/>
<effectiveTime xsi:type="IVL_TS">
<low nullFlavor="NI"/>
</effectiveTime>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<templateId root="2.16.840.1.113883.3.3251.1.6"/>
<templateId root="2.16.840.1.113883.10.20.22.5.6" extension="2019-10-01"/>
<time value="20250913082104+0530"/>
<assignedAuthor>
<templateId root="2.16.840.1.113883.3.3251.1.7"/>
<id extension="30174" root="1.3.6.1.4.1.22812.3.2009693.3"/>
<id extension="7894561234" root="2.16.840.1.113883.4.6"/>
<code code="260000000X" codeSystem="2.16.840.1.113883.6.101" displayName="Ambulatory Health Care Facilities" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/>
<representedOrganization>
<id extension="21" root="1.3.6.1.4.1.22812.3.2009693.3"/>
<id root="2.16.840.1.113883.4.2" nullFlavor="UNK"/>
<id root="2.16.840.1.113883.4.6" nullFlavor="UNK"/>
<name>In Office</name>
<telecom nullFlavor="UNK"/>
</representedOrganization>
</assignedAuthor>
</author>
<entryRelationship typeCode="SPRT">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.69" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.69"/>
<id root="1.3.6.1.4.1.22812.3.2009693.3.4.20" extension="794293300229"/>
<code code="88121-9" codeSystem="2.16.840.1.113883.6.1" displayName="CCDA Hunger Vital Sign" codeSystemName="LOINC"/>
<text>
<reference value="#_aaaaef06-64d2-421a-b41d-8a7f0bc4e051"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20250912225104-0400"/>
<value xsi:type="ST">Assessment Score 2</value>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.86"/>
<id nullFlavor="NI"/>
<code code="88122-7 " codeSystem="2.16.840.1.113883.6.1" displayName="I/we worried whether our food would run out before we got money to buy more." codeSystemName="LOINC"/>
<statusCode code="completed"/>
<value xsi:type="CD" code="LA28397-0" codeSystem="2.16.840.1.113883.6.1" displayName="1-Often true" codeSystemName="LOINC"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.86"/>
<id nullFlavor="NI"/>
<code code="88123-5 " codeSystem="2.16.840.1.113883.6.1" displayName="The food we bought just didn't last and we didn't have money to get more." codeSystemName="LOINC"/>
<statusCode code="completed"/>
<value xsi:type="CD" code="LA28397-0" codeSystem="2.16.840.1.113883.6.1" displayName="1-Often true" codeSystemName="LOINC"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entry>

[Mohan Kundena Goud]

Hi,

We reviewed the SDOH Assessment issue under the Social History section.

Based on the validation messages, the issue appears to be related to the way the Hunger Vital Sign assessment is being represented in the CCDA:

• LOINC 88121-9 (CCDA Hunger Vital Sign) is currently populated with Assessment Score 2. The validator indicates that the Assessment Value Comparison data is not expected for this scenario.

• LOINC 88122-7 and 88123-5 are the supporting observations expected by the scenario, but the validator is not recognizing the submitted data as matching observations.

• In the submitted XML, both supporting observations are represented with entryRelationship typeCode="COMP" under the 88121-9 observation. This may be the reason they are not being matched as the expected supporting observations.

• We also noticed that the code values for 88122-7 and 88123-5 contain a trailing space ("88122-7 " and "88123-5 "). This should be removed, as the code should be exactly 88122-7 and 88123-5.

Could you please review the expected CCDA structure for the SDOH Assessment/Hunger Vital Sign scenario and confirm whether the supporting observations should be represented differently? In particular, please confirm the expected relationship type and placement for LOINC 88122-7 and 88123-5, as well as whether the 88121-9 assessment value should be omitted or represented differently.

Once we have confirmation of the expected structure, we can make the required changes and retest the CCDA.

Thanks, 

Mohan Kundena Goud

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With Regards
Mohan Goud Kundena

[sridevi Brijesh]

Thank you Mohan,

I have corrected the space issue in the LOINC codes. We have represented  both supporting observations are represented with entryRelationship typeCode="COMP" under the 88121-9 observation  correctly as per the  CCDA structure for the SDOH Assessment/Hunger Vital Sign scenario.

Please let us know.