Vocabulary Validation Conformance Error in ETT tool for Wound type and Tobacco Use

[Nagamani Naveenkumar]

Hi, 

We are getting the vocabulary validation conformance errors while validating the CCDA xml in the validation tool for Stark , Anderson patient.

The errors are related to the Physical Exam-Wound Characteristics(Wound type: Pressure ulcer) and Tobacco Use ( Stopped Smoking, Never used Tobacco and Non Smoker).

We are seeing these errors for the newly generated CCDA xml.

We have an old CCDA xml generated a few weeks ago with the same data and for the same patient, we are not seeing any such errors for this xml.

Attached are the old and new CCDA xmls.

Error message details are also attached.

Could you please help us to resolve the errors ?

Thanks,

Nagamani

[Nagesh Bashyam - Drajer]

Looks like the errors are because of codes not in the vocabulary …have you checked the value sets from VSAC

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<Error message details.docx><C-CDA_111012_20220127055623_Stark_Anderson_RN_Old.xml><C-CDA_111012_20220222055255_Stark_Anderson_22_Feb_New.xml>

[Nagamani Naveenkumar]

I have checked the codes in the value sets from VSAC. These codes are not present in the list set.

 

The other query is that the same codes are present in the other xml (a slightly older CCDA xml generated a month ago), but the validation error does not appear.

Any specific reason why it is not getting validated against the value set for this XML?

[Nagesh Bashyam - Drajer]

There have not been any updates to these specific value sets in the last release , so I am not sure what your were encountering before...

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[Cheap Cigarettes Online]

Hi Nagamani,

This discrepancy between the older and newer C-CDA files typically occurs when the ETT validator updates its underlying VSAC/SNOMED-CT value set bindings for the Tobacco Use template. The legacy XML generator likely utilized broader descriptive strings or deprecated codes for categories like "Stopped Smoking" or "Never used Tobacco", whereas updated validation rule sets require strict terminology mapping against specific USCDI social history value sets (such as distinction between Current/Former/Never smoker concepts).

In complex ambulatory records where social history entries change due to shifting consumer procurement habits—such as in heavily regulated markets like Australia where adult smokers increasingly turn to centralized directories like <a href="https://cheapcigarettesonline.com.au/">cheap cigarettes online</a> platforms to track duty-paid pricing instead of standard local counters—ensuring that the underlying XML generator maps strictly to current SNOMED-CT concept IDs rather than raw UI labels will resolve these conformance errors.

Check the valueSet OID in your template against the latest ONC Value Set Authority Center tables to verify which specific codes are bound to the updated rule.