NQF0418 not producing correct results

[srinathr99]

The solution for this was identified by Andy, but I was asked to post it here as well.
(QRDA Cat1 included in the end )
Here are the details of the test we ran for NQF 0418. The data for the test patient was generated in cypress. I have also attached the QRDA cat1 file for reference.

Philip Tate (1972)
Dx= Depression (03/01/2012 10AM - unknown)
Procedure= Adult Depression Screening; LOINC value (03/01/2012 11-11:15 AM)
Result= Neg
Encounter= 99201; Office Visit (03/01/2012)
Encounter= 99201; Office Visit (07/01/2012)

IPP= Over the age of 12 + "Depression Screening" complete during MP
Denomoinator= Same as IPP
D Exclusion= Exclude consumers from the Denominator if the consumer has an active Dx of Depression or Bipolar before the Depression Screening
Numerator= Screening is Negative or Screening is Positive and had a follow-up event
D Exceptions= After Numerator calculation, evaluate remaining consumers and retroactively remove any from the Denominator if they have a Screening result of Medical or Patient Reason for not having it completed

Issues
When we looked at the data in popHealth, it only showed Philip Tate in the IPP and Denominator. Based on the above information, he should have also fallen into the Denominator Exclusion because he has a Diagnosis of Depression that was active during the time of him receiving the Depression Screening.
We then did a test by first changing the date and time for the diagnosis by making it no longer active when the screening occurred and then a second test of removing the diagnosis all together-- neither of those changes resulted in Philip Tate being placed in the Numerator; which was the expected result.

---

QRDA cat1 used in above test:

<title>QRDA Incidence Report</title> 202 Burlington Rd. Bedford MA 01730 US Philip Tate 202 Burlington Rd. Bedford MA 01730 US Cypress Cypress Cypress Test Deck 202 Burlington Rd. Bedford MA 01730 US 202 Burlington Rd. Bedford MA 01730 US Henry Seven Cypress

<title>Measure Section</title>

eMeasure Title	Version neutral identifier	eMeasure Version Number	Version specific identifier
Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan	9A031E24-3D9B-11E1-8634-00237D5BF174	3	40280381-3E93-D1AF-013E-9F642782222A

Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

        <component>
    <section>
      <!-- This is the templateId for Reporting Parameters section -->
      <templateId root="2.16.840.1.113883.10.20.17.2.1"/>
      <code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
      <title>Reporting Parameters</title>
      <text>
        <list>
          <item>Reporting period: January 1st, 2012 00:00 - December 31st, 2012 23:59</item>
        </list>
      </text>
      <entry typeCode="DRIV">
        <act classCode="ACT" moodCode="EVN">
          <!-- This is the templateId for Reporting Parameteres Act -->
          <templateId root="2.16.840.1.113883.10.20.17.3.8"/>
          <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
          <effectiveTime>
            <low value="20120101000000"/>
            <high value="20121231235900"/>
          </effectiveTime>
        </act>
      </entry>
    </section>
  </component>
        <component>
    <section>
      <!-- This is the templateId for Patient Data section -->
      <templateId root="2.16.840.1.113883.10.20.17.2.4"/>
      <!-- This is the templateId for Patient Data QDM section -->
      <templateId root="2.16.840.1.113883.10.20.24.2.1"/>
      <code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
      <title>Patient Data</title>
      <text>

      </text>

Risk Category Assessment: Adult Depression Screening (Code List: 2.16.840.1.113883.3.600.2449)

<effectiveTime>
  <low value='20120301110000'/>
  <high value='20120301111500'/>
</effectiveTime>
    <value code="428171000124102" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD" sdtc:valueSet='2.16.840.1.113883.3.600.2454'><originalText>Depression Screening Result</originalText></value>

Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001)