Validator does not appear to recognize Problem Code: 55607006 in the right spot

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kped...@athenahealth.com

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May 4, 2018, 1:02:04 PM5/4/18
to Edge Test Tool (ETT)

We are running into an example where the validator seem to be giving maybe a false negative.

 

Our Problem observation looks like this

 

                            <entryRelationship typeCode="SUBJ">

                                <observation classCode="OBS" moodCode="EVN">

                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>

                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>

                                    <id root="20844084-380c-4f64-87a4-9aeb46bca3a6"/>

                                    <code code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem">

                                        <translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem HL7.CCDAR2"/>

                                    </code>

                                    <statusCode code="completed"/>

                                    <effectiveTime>

                                        <low value="20150722000000-0500"/>

                                        <high value="20170501000000-0500"/>

                                    </effectiveTime>

                                    <value code="699134002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Caregiver annual health check" xsi:type="CD"/>

                                </observation>

                            </entryRelationship>

 

Which gives this error on the validation

 

Error - 

The scenario contains problem observation for Problem Code: 55607006 , however there is no matching observation in the submitted CCDA.

Line number: 0

 

This is obvious not true since the code is there. If we flip the code in value and code tag around, the validator does not throw an error and the entire document passes.

 

                            <entryRelationship typeCode="SUBJ">

                                <observation classCode="OBS" moodCode="EVN">

                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>

                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>

                                    <id root="20844084-380c-4f64-87a4-9aeb46bca3a6"/>

                                    <code code="699134002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem">

                                        <translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem HL7.CCDAR2"/>

                                    </code>

                                    <statusCode code="completed"/>

                                    <effectiveTime>

                                        <low value="20150722000000-0500"/>

                                        <high value="20170501000000-0500"/>

                                    </effectiveTime>

                                    <value code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Caregiver annual health check" xsi:type="CD"/>

                                </observation>

                            </entryRelationship>

 

 

Could we please get some advice as to how we proceed? We do not seem to have this issue on other flavors of the data, just sample 2 ambulatory for (b)(6) Sending.

 

Kind Regards

 

Klavs Pedersen | Lead Member of Technical Staff

800 West Cesar Chavez Street | Austin, TX | 78701

O: 512.808.4647 | athenahealth.com

Integration Services

Nate Stelzner

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May 4, 2018, 1:54:10 PM5/4/18
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I am seeing the same issue, and according to the Implementation Guide we have the code and value in the correct places, as does Klavs above.

Nagesh Bashyam - Drajer

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May 4, 2018, 2:06:04 PM5/4/18
to Nate Stelzner, Edge Test Tool (ETT)
The scenario requires “No Known Problems”, please refer to the HL7 example below on how to code it ..


You are having the issue because what you are sending in value element is not matching what is expected for No Known Problems.



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Nagesh Bashyam - Drajer

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May 4, 2018, 2:07:43 PM5/4/18
to kped...@athenahealth.com, Edge Test Tool (ETT)
Please refer to the HL7 example below on how to code “No Known Problems"

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kped...@athenahealth.com

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May 4, 2018, 2:25:36 PM5/4/18
to Edge Test Tool (ETT)
Thanks for you swift reply, turned out "Caregiver annual health check" had been entered as a problem. We now have "No Problems" correctly in there however the validator does not seem to recognize the code for that

                                <observation classCode="OBS" moodCode="EVN" negationInd="true">
                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id root="53e0a838-4e99-4759-9668-8ae4ee38e2a2"/>
                                    <code code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem">
                                        <translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem HL7.CCDAR2"/>
                                    </code>
                                    <statusCode code="completed"/>
                                    <effectiveTime>
                                        <low nullFlavor="NI"/>
                                    </effectiveTime>
                                    <value code="160245001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="No current problems or disability" xsi:type="CD"/>
                                </observation>

Nagesh Bashyam - Drajer

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May 4, 2018, 2:47:51 PM5/4/18
to kped...@athenahealth.com, Edge Test Tool (ETT)
No problem, the code that is expected is what is provided in the HL7 Example Task Force example. 
If you are going to use a different code than that, you will have to work with your ATL to allow the use of a different code.

Thanks
Dragon

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