Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

Frequently Asked Questions About Meaningful Use: Testing, Validation, and Implementation Guide (Questions 14–29)

  1. Will the cancer case reporting Clinical Document Architecture (CDA) validation be part of the Messaging Quality Framework (MQF) testing process?
  2. What is the process for attestation?
  3. Is NIST’s validation site updated routinely? Will my sample fail validation if I use an invalid code?
  4. Will my sample fail validation if I use an ICD-10-CM code to identify problems?
  5. A human-readable demonstration is not required for certification. Is the EHR vendor supposed to include a style sheet for human readability?
  6. What do I do if I have problems accessing the NIST validation tool?
  7. The test procedure for transmission of data to cancer registries has 18 test cases in 6 categories. Who selects which cases in each category the EHR vendor will need to test?
  8. Is there a list of codes that represent cancers and those that represent comorbidities?
  9. The Reference entry in the Coded Results section is not linked to any further information in the Cancer Implementation Guide. Where can I get this information?
  10. Is there a data dictionary of diagnosis and procedure codes to check whether cancers that are diagnosed or treated in my practice should be reported to my state cancer registry?
  11. Do state cancer registries want a final report when the cancer is in remission?
  12. Is the cancer report for an encounter or is it cumulative?
  13. Should the cancer report contain all procedures, problems, and medications, or only those relevant to the cancer diagnosis?
  14. Should the EHR submit a cancer report whenever there is a primary diagnosis of cancer?
  15. The Cancer Implementation Guide requires the physician specialty value to use the National Uniform Claim Committee for provider types. Do we have to use all of these codes in the drop-down list in our EHR?
  16. Do state cancer registries want only the most current occupation and industry, or the entire history?
  1. Will the cancer case reporting Clinical Document Architecture (CDA) validation be part of the Messaging Quality Framework (MQF) testing process?

The three public health areas that were in Meaningful Use (MU) Stage 1 use the Messaging Quality Framework (MQF). CDC is developing a validation tool for cancer reports. NIST developed the Meaningful Use Cancer Registry Report Validation tool to validate the document’s structure, but a tool that performs a more detailed validation is needed. We are pursuing incorporation of the cancer validation tool into the MQF testing process.

  1. What is the process for attestation?

The Centers for Medicare & Medicaid Services (CMS), not the state public health agency (PHA), deals with the provider attestation process. Providers can find details on this process on the CMS Web site.

  1. Is NIST’s validation site updated routinely? Will my sample fail validation if I use an invalid code?

The NIST validation tool is updated as issues are identified. The change log is available in the download package. The validation tool doesn’t test for correctly coded entry-level data, so the document shouldn’t fail the validator if you use a value from an invalid code system. Coded entry-level data will be validated manually by the testing bodies.

  1. Will my sample fail validation if I use an ICD-10-CM code to identify problems?

No. The Cancer Implementation Guide says the code should use a controlled vocabulary, such as ICD-9 or SNOMED CT, and that “The table below is an incomplete listing of acceptable values…” (page 75). ICD-10-CM is acceptable for problems.

  1. A human-readable demonstration is not required for certification. Is the EHR vendor supposed to include a style sheet for human readability?

The Cancer Implementation Guide requires Level 2 text in every section, so human readability is required. The test procedure tells vendors to use the HL7 CDA style sheet for rendering if needed. See page 10 of the Test Procedure for §170.314(f)(6) Transmission to cancer registries – ambulatory setting only [PDF-463KB].

  1. What do I do if I have problems accessing the NIST validation tool?

Support for the NIST tool is available by submitting questions to the user’s group. Inquiries may also be sent to this user group by e-mail. If problems persist, you can contact meaningfuluse@cdc.gov.

  1. The test procedure for transmission of data to cancer registries has 18 test cases in 6 categories. Who selects which cases in each category the EHR vendor will need to test?

The Test Procedure for §170.314(f)(6) Transmission to cancer registries – ambulatory setting only [PDF-463KB] requires the tester to select one case from each of the six categories (see page 4).

  1. Is there a list of codes that represent cancers and those that represent comorbidities?

Cancer registry reportability lists for ICD-9-CM and ICD-10-CM are in the PHIN VADS. Depending on the cancer, anything can be a comorbidity diagnosis, so there is no list of comorbidities. All diagnoses should be included in the cancer report.

  1. The Reference entry in the Coded Results section is not linked to any further information in the Cancer Implementation Guide. Where can I get this information?

Details on the Reference entry can be found in the Integrating the Healthcare Enterprise: IHE Patient Care Coordination (PCC) Technical Framework Volume 2. [PDF-1.3MB]

The Reference entry is not required. For the Coded Results section, the Procedure and Simple Observation entries are required. If cardinality and the conformance verbs conflict, the conformance verb takes precedence.

  1. Is there a data dictionary of diagnosis and procedure codes to check whether cancers that are diagnosed or treated in my practice should be reported to my state cancer registry?

Yes. Use the ICD-9-CM or ICD-10-CM Reportability List in the Cancer Implementation Guide [PDF-1.9MB] (page 8).

Direct links in PHIN VADS:

  1. Do state cancer registries want a final report when the cancer is in remission?

The Cancer Implementation Guide does not instruct providers to send a report in this case.

  1. Is the cancer report for an encounter or is it cumulative?

The Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries [PDF-1.9MB] (page 8) requires the cancer report to be cumulative.

  1. Should the cancer report contain all procedures, problems, and medications, or only those relevant to the cancer diagnosis?

The report should contain all of this information. Cancer registries collect information on comorbidities, so all problems are relevant. For procedures, medications, and other sections, the EHRs do not have to filter out information that is not relevant to cancer. EHR vendors should apply appropriate filters to avoid sending information that has additional privacy or confidentiality constraints. For example, depending on state regulations or provider policies, “AIDS” may be a problem that should not be reported.

  1. Should the EHR submit a cancer report whenever there is a primary diagnosis of cancer?

Yes.

  1. The Cancer Implementation Guide requires the physician specialty value to use the National Uniform Claim Committee for provider types. Do we have to use all of these codes in the drop-down list in our EHR?

This decision is up to the individual implementer. From the cancer reporting perspective, you can include only codes that are relevant to the specific provider or practice using the system.

  1. Do state cancer registries want only the most current occupation and industry, or the entire history?

Registries capture usual occupation and industry, not necessarily the most current. The current occupation is often recorded as “retired,” which leads to a loss of important information about the patient’s occupation history that could be relevant to their cancer. Registries would like to receive information on occupation and industry that is as complete as possible. They can accept multiple occupations and industries if submitted.

 
Contact Us:
  • Centers for Disease Control and Prevention
    Division of Cancer Prevention and Control
    c/o CDC Warehouse
    3719 N Peachtree Rd
    Building 100 MS F-76
    Chamblee GA 30341
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348
  • Contact CDC-INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #