Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build
Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build
Draft dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2025/ and changes regularly. See the Directory of published versions
| Official URL: https://madie.cms.gov/Measure/CMS131FHIRDiabetesEyeExam#effective-data-requirements | Version: 1.0.000 | |||
| Active | Responsible: National Committee for Quality Assurance | Computable Name: EffectiveDataRequirements | ||
| Metadata | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | module-definition from http://terminology.hl7.org/CodeSystem/library-type | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Dependency |
Description: USQualityCore model information
Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild |
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| Dependency |
Description: USCore model information
Resource: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived |
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| Dependency |
Description: FHIR model information
Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 |
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| Dependency |
Description: Library SDE
Resource: SupplementalDataElements version: 6.1.000 Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000 |
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| Dependency |
Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 |
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| Dependency |
Description: Library USCommon
Resource: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot |
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| Dependency |
Description: Library FHIRCommon
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0 |
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| Dependency |
Description: Library Status
Resource: Status version: 2.1.000 Canonical URL: https://madie.cms.gov/Library/Status|2.1.000 |
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| Dependency |
Description: Library Hospice
Resource: Hospice version: 7.1.000 Canonical URL: https://madie.cms.gov/Library/Hospice|7.1.000 |
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| Dependency |
Description: Library AIFrailLTCF
Resource: AdvancedIllnessandFrailty version: 2.1.000 Canonical URL: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|2.1.000 |
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| Dependency |
Description: Library CMD
Resource: http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot Canonical URL: http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot |
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| Dependency |
Description: Library PalliativeCare
Resource: PalliativeCare version: 2.1.000 Canonical URL: https://madie.cms.gov/Library/PalliativeCare|2.1.000 |
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| Dependency |
Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions) Canonical URL: http://snomed.info/sct |
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| Dependency |
Description: Code system ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status |
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| Dependency |
Description: Code system ObservationCategoryCodes
Resource: Observation Category Codes Canonical URL: http://terminology.hl7.org/CodeSystem/observation-category |
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| Dependency |
Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC) Canonical URL: http://loinc.org |
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| Dependency |
Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical |
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| Dependency |
Description: Value set Diabetic Retinopathy
Resource: Diabetic Retinopathy Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327 |
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| Dependency |
Description: Value set Retinal or Dilated Eye Exam
Resource: Retinal or Dilated Eye Exam Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.115.12.1088 |
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| Dependency |
Description: Value set Autonomous Eye Exam Result or Finding
Resource: Autonomous Eye Exam Result or Finding Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1004.2616 |
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| Dependency |
Description: Value set Diabetic Retinopathy Severity Level
Resource: Diabetic Retinopathy Severity Level Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1266 |
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| Dependency |
Description: Value set Office Visit
Resource: Office Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 |
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| Dependency |
Description: Value set Annual Wellness Visit
Resource: Annual Wellness Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240 |
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| Dependency |
Description: Value set Preventive Care Services Established Office Visit, 18 and Up
Resource: Preventive Care Services Established Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 |
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| Dependency |
Description: Value set Preventive Care Services Initial Office Visit, 18 and Up
Resource: Preventive Care Services Initial Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 |
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| Dependency |
Description: Value set Home Healthcare Services
Resource: Home Healthcare Services Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 |
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| Dependency |
Description: Value set Ophthalmological Services
Resource: Ophthalmological Services Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285 |
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| Dependency |
Description: Value set Telephone Visits
Resource: Telephone Visits Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080 |
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| Dependency |
Description: Value set Diabetes
Resource: Diabetes Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001 |
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| Dependency |
Description: Value set Payer Type
Resource: Payer Type Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 |
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| Dependency |
Description: Value set Encounter Inpatient
Resource: Encounter Inpatient Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307 |
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| Dependency |
Description: Value set Hospice Encounter
Resource: Hospice Encounter Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003 |
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| Dependency |
Description: Value set Hospice Care Ambulatory
Resource: Hospice Care Ambulatory Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584 |
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| Dependency |
Description: Value set Hospice Diagnosis
Resource: Hospice Diagnosis Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165 |
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| Dependency |
Description: Value set Frailty Device
Resource: Frailty Device Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300 |
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| Dependency |
Description: Value set Frailty Diagnosis
Resource: Frailty Diagnosis Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074 |
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| Dependency |
Description: Value set Frailty Encounter
Resource: Frailty Encounter Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088 |
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| Dependency |
Description: Value set Frailty Symptom
Resource: Frailty Symptom Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075 |
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| Dependency |
Description: Value set Advanced Illness
Resource: Advanced Illness Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082 |
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| Dependency |
Description: Value set Dementia Medications
Resource: Dementia Medications Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510 |
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| Dependency |
Description: Value set Palliative Care Diagnosis
Resource: Palliative Care Diagnosis Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167 |
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| Dependency |
Description: Value set Palliative Care Encounter
Resource: Palliative Care Encounter Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090 |
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| Dependency |
Description: Value set Palliative Care Intervention
Resource: Palliative Care Intervention Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135 |
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| Data Requirement |
Type: Patient
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient
Must Support Elements: ombCategory, detailed, text |
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| Data Requirement |
Type: Patient
Profile(s): Patient Must Support Elements: birthDate |
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| Data Requirement |
Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns
Must Support Elements: code Code Filter(s): Path: code ValueSet: Diabetic Retinopathy |
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| Data Requirement |
Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns
Must Support Elements: code Code Filter(s): Path: code Code(s): SNOMED CT: 15665641000119103 (Anophthalmos of bilateral eyes (disorder)) |
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| Data Requirement |
Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis
Must Support Elements: code Code Filter(s): Path: code ValueSet: Diabetic Retinopathy |
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| Data Requirement |
Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis
Must Support Elements: code, onset Code Filter(s): Path: code ValueSet: Diabetes |
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| Data Requirement |
Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis
Must Support Elements: code Code Filter(s): Path: code Code(s): SNOMED CT: 15665641000119103 (Anophthalmos of bilateral eyes (disorder)) |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, effective, status, category Code Filter(s): Path: code ValueSet: Retinal or Dilated Eye Exam |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, value, effective, status, category Code Filter(s): Path: code Code(s): LOINC: 105914-6 (Eye Diabetic retinopathy screening Autonomous artificial intelligence) Path: value ValueSet: Autonomous Eye Exam Result or Finding |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, value, effective, status, category Code Filter(s): Path: code Code(s): LOINC: 71490-7 (Left eye Diabetic retinopathy severity level by Ophthalmoscopy) Path: value ValueSet: Diabetic Retinopathy Severity Level |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, value, effective, status, category Code Filter(s): Path: code Code(s): LOINC: 71491-5 (Right eye Diabetic retinopathy severity level by Ophthalmoscopy) Path: value ValueSet: Diabetic Retinopathy Severity Level |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, value, effective, status, category Code Filter(s): Path: code Code(s): LOINC: 71491-5 (Right eye Diabetic retinopathy severity level by Ophthalmoscopy) Path: value |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result
Must Support Elements: code, value, effective, status, category Code Filter(s): Path: code Code(s): LOINC: 71490-7 (Left eye Diabetic retinopathy severity level by Ophthalmoscopy) Path: value |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Office Visit |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Annual Wellness Visit |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care Services Established Office Visit, 18 and Up |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care Services Initial Office Visit, 18 and Up |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Home Healthcare Services |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Ophthalmological Services |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Telephone Visits |
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| Data Requirement |
Type: Coverage
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage
Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type |
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| Data Requirement |
Type: Condition
Profile(s): Condition Must Support Elements: abatement, verificationStatus, onset, recordedDate, clinicalStatus |
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| Data Requirement |
Type: Condition
Profile(s): Condition Must Support Elements: code, verificationStatus Code Filter(s): Path: code ValueSet: Hospice Diagnosis |
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| Data Requirement |
Type: Condition
Profile(s): Condition Must Support Elements: code, verificationStatus Code Filter(s): Path: code ValueSet: Frailty Diagnosis |
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| Data Requirement |
Type: Condition
Profile(s): Condition Must Support Elements: code, verificationStatus Code Filter(s): Path: code ValueSet: Advanced Illness |
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| Data Requirement |
Type: Condition
Profile(s): Condition Must Support Elements: code, verificationStatus Code Filter(s): Path: code ValueSet: Palliative Care Diagnosis |
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| Data Requirement |
Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period Code Filter(s): Path: type ValueSet: Encounter Inpatient |
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| Data Requirement |
Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Hospice Encounter |
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| Data Requirement |
Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Frailty Encounter |
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| Data Requirement |
Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Palliative Care Encounter |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, value, effective, status Code Filter(s): Path: code Code(s): LOINC: 45755-6 (Hospice care [Minimum Data Set]) Path: value |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, value, effective, status Code Filter(s): Path: code Code(s): LOINC: 98181-1 (Medical equipment used) Path: value ValueSet: Frailty Device |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, status Code Filter(s): Path: code Code(s): LOINC: 71802-3 (Housing status) |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, value, status Code Filter(s): Path: code Code(s): LOINC: 71802-3 (Housing status) Path: value |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, status Code Filter(s): Path: code Code(s): LOINC: 71007-9 (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)) |
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| Data Requirement |
Type: ServiceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest
Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory |
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| Data Requirement |
Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure
Must Support Elements: code, performed Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory |
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| Data Requirement |
Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure
Must Support Elements: code, performed Code Filter(s): Path: code ValueSet: Palliative Care Intervention |
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| Data Requirement |
Type: DeviceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-devicerequest
Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Frailty Device |
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| Data Requirement |
Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation
Must Support Elements: code, effective, status Code Filter(s): Path: code ValueSet: Frailty Symptom |
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| Data Requirement |
Type: Medication
Profile(s): Medication Must Support Elements: id, code Code Filter(s): Path: code ValueSet: Dementia Medications |
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| Data Requirement |
Type: MedicationRequest
Profile(s): MedicationRequest Must Support Elements: medication.reference, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, dispenseRequest.validityPeriod |
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| Data Requirement |
Type: MedicationRequest
Profile(s): MedicationRequest Must Support Elements: medication, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, dispenseRequest.validityPeriod Code Filter(s): Path: medication ValueSet: Dementia Medications |
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| Parameters | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Generated using version 0.5.4 of the sample-content-ig Liquid templates | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||