Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates. (id = "example-eligibility-criteria-ada-rec-bariatric")

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    <Group> 
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            <code value="64572001"/> 
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          <reference value="ValueSet/Acute-Coronary-Heart-Disease-Value-Set"/> 
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          <display value="Acute Coronary Heart Disease Value Set"/> 
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        <exclude value="false"/> 
        <description value="acute coronary heart disease (a value set covering many forms)"/> 
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            <system value="http://snomed.info/sct"/> 
            <code value="71388002"/> 
            <display value="Procedure (procedure)"/> 
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      <title value="Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented
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      <description value="Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented
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          <coding> 
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            <code value="363346000"/> 
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      <characteristic> 
        <code> 
          <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="64572001"/> 
            <display value="Disease (disorder)"/> 
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            <system value="http://snomed.info/sct"/> 
            <code value="254701007"/> 
            <display value="Basal cell carcinoma of skin (disorder)"/> 
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        <exclude value="true"/> 
        <description value="(except basal cell skin cancer)"/> 
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          <coding> 
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            <code value="64572001"/> 
            <display value="Disease (disorder)"/> 
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          <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="109355002"/> 
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        <description value="(except cancer in situ)"/> 
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        <valueCodeableConcept> 
          <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="395100000"/> 
            <display value="No evidence of cancer found (situation)"/> 
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        <exclude value="true"/> 
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              <value value="-5"/> 
              <unit value="years"/> 
              <system value="http://unitsofmeasure.org"/> 
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              <value value="0"/> 
              <unit value="years"/> 
              <system value="http://unitsofmeasure.org"/> 
              <code value="a"/> 
            </high> 
          </offsetRange> 
          <text value="for five years"/> 
        </timing> 
      </characteristic> 
    </Group> 
  </contained> 
  <name value="Recommend bariatric surgery if BMI 35 or higher"/> 
  <title value="RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA
   Recommendation 8.16)"/> 
  <status value="active"/> 
  <publisher value="Computable Publishing LLC"/> 
  <contact> 
    <telecom> 
      <system value="email"/> 
      <value value="support@computablepublishing.com"/> 
    </telecom> 
  </contact> 
  <description value="Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body
   Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0
   kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve
   durable weight loss and improvement in comorbidities (including hyperglycemia)
   with nonsurgical methods. [[4]] Screened surgical candidates."/> 
  <copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/> 
  <type value="person"/> 
  <membership value="definitional"/> 
  <combinationMethod value="all-of"/> 
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    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="397669002"/> 
        <display value="Age"/> 
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      <comparator value="&gt;="/> 
      <unit value="years"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="a"/> 
    </valueQuantity> 
    <exclude value="false"/> 
    <description value="Adult"/> 
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  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
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    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="44054006"/> 
        <display value="Diabetes mellitus type 2 (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="false"/> 
    <description value="Diabetes mellitus type 2 (disorder)"/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <text value="Defined by Reference"/> 
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    <exclude value="false"/> 
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  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
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      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="44054006"/> 
        <display value="Diabetes mellitus type 2 (disorder)"/> 
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    <exclude value="false"/> 
    <description value="Diabetes mellitus type 2 (disorder)"/> 
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    <code> 
      <text value="Defined by Reference"/> 
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        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
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          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
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      <text value="in the past six months"/> 
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  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <text value="Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral
       vascular disease."/> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral
     vascular disease. This may be possible to encode as presence of Disease(disorder)
     without 'in remission. Placeholder for now to represent 'screened surgical candidate'."/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <text value="Cardiac stress test indicating that surgery or IMM would not be safe."/> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="Cardiac stress test indicating that surgery or IMM would not be safe. Placeholder
     for now to represent 'screened surgical candidate'."/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="59282003"/> 
        <display value="Pulmonary embolism (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="Pulmonary embolus in the past six months. Placeholder for now to represent 'screened
     surgical candidate'."/> 
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      <offsetRange> 
        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </low> 
        <high> 
          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </high> 
      </offsetRange> 
      <text value="in the past six months"/> 
    </timing> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64572001"/> 
        <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="64156001"/> 
        <display value="Thrombophlebitis (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="Thrombophlebitis in the past six months. Placeholder for now to represent 'screened
     surgical candidate'."/> 
    <timing> 
      <offsetRange> 
        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </low> 
        <high> 
          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </high> 
      </offsetRange> 
      <text value="in the past six months"/> 
    </timing> 
  </characteristic> 
  <characteristic> 
    <code> 
      <text value="Defined by Reference"/> 
    </code> 
    <valueReference> 
      <reference value="#Cancer"/> 
      <type value="Group"/> 
      <display value="Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented
       to be disease-free for five years"/> 
    </valueReference> 
    <exclude value="true"/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <text value="Defined by CodeableConcept"/> 
    </code> 
    <valueCodeableConcept> 
      <text value="history of coagulopathy"/> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="History of coagulopathy. Placeholder for now to represent 'screened surgical candidate'."/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="718-7"/> 
        <display value="Hemoglobin [Mass/volume] in Blood"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <value value="-1"/> 
      <comparator value="&lt;="/> 
      <unit value="GramsPerDeciLiter"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="g/dL"/> 
    </valueQuantity> 
    <exclude value="true"/> 
    <description value="Significant anemia (hemoglobin 1.0 g or more below normal range). Placeholder for
     now to represent 'screened surgical candidate'."/> 
    <offset> 
      <coding> 
        <system value="http://hl7.org/fhir/characteristic-offset"/> 
        <code value="LNL"/> 
        <display value="Lower Normal Limit"/> 
      </coding> 
    </offset> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="2160-0"/> 
        <display value="Creatinine [Mass/volume] in Serum or Plasma"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <value value="1.5"/> 
      <comparator value="&gt;="/> 
      <unit value="MilliGramsPerDeciLiter"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mg/dL"/> 
    </valueQuantity> 
    <exclude value="true"/> 
    <description value="Serum creatinine ≥ 1.5 mg/dl. Placeholder for now to represent 'screened surgical
     candidate'."/> 
  </characteristic> 
</Group>