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

Library: Library

Official URL: https://madie.cms.gov/Measure/CMS146FHIRApproTestPharyngitis#effective-data-requirements Version: 1.1.000
Active Responsible: National Committee for Quality Assurance Computable Name: EffectiveDataRequirements
Metadata
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
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
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
Dependency Description: Library SDE
Resource: SupplementalDataElements version: 6.1.000
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000
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
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
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
Dependency Description: Library Status
Resource: Status version: 2.1.000
Canonical URL: https://madie.cms.gov/Library/Status|2.1.000
Dependency Description: Library Hospice
Resource: Hospice version: 7.1.000
Canonical URL: https://madie.cms.gov/Library/Hospice|7.1.000
Dependency Description: Library Antibiotic
Resource: Antibiotic version: 2.1.000
Canonical URL: https://madie.cms.gov/Library/Antibiotic|2.1.000
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
Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Dependency Description: Code system CPT
Resource: Current Procedural Terminology (CPT®)
Canonical URL: http://www.ama-assn.org/go/cpt
Dependency Description: Code system ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status
Dependency Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Value set Group A Streptococcus Test
Resource: Group A Streptococcus Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1012
Dependency Description: Value set Emergency Department Evaluation and Management Visit
Resource: Emergency Department Evaluation and Management Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010
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
Dependency Description: Value set Medical Disability Exam
Resource: Medical Disability Exam
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1073
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
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
Dependency Description: Value set Virtual Encounter
Resource: Virtual Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Dependency Description: Value set Outpatient Consultation
Resource: Outpatient Consultation
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
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
Dependency Description: Value set Preventive Care Services Group Counseling
Resource: Preventive Care Services Group Counseling
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027
Dependency Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17
Resource: Preventive Care Services, Initial Office Visit, 0 to 17
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022
Dependency Description: Value set Preventive Care Services Individual Counseling
Resource: Preventive Care Services Individual Counseling
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
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
Dependency Description: Value set Preventive Care, Established Office Visit, 0 to 17
Resource: Preventive Care, Established Office Visit, 0 to 17
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024
Dependency Description: Value set Antibiotic Medications for Pharyngitis
Resource: Antibiotic Medications for Pharyngitis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1001
Dependency Description: Value set Acute Pharyngitis
Resource: Acute Pharyngitis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011
Dependency Description: Value set Acute Tonsillitis
Resource: Acute Tonsillitis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1012
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
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
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
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
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
Dependency Description: Value set Comorbid Conditions for Respiratory Conditions
Resource: Comorbid Conditions for Respiratory Conditions
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1025
Dependency Description: Value set Competing Conditions for Respiratory Conditions
Resource: Competing Conditions for Respiratory Conditions
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1017
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
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: code, value, status
Code Filter(s):
Path: code
ValueSet: Group A Streptococcus Test
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: code, value, effective, status
Code Filter(s):
Path: code
ValueSet: Group A Streptococcus Test
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Emergency Department Evaluation and Management Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Home Healthcare Services
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Medical Disability Exam
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Office Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Telephone Visits
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Virtual Encounter
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Outpatient Consultation
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
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Group Counseling
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, 0 to 17
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Individual Counseling
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
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Preventive Care, Established Office Visit, 0 to 17
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: birthDate
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Antibiotic Medications for Pharyngitis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, intent, authoredOn, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.validityPeriod
Code Filter(s):
Path: medication
ValueSet: Antibiotic Medications for Pharyngitis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication.reference, status, intent, authoredOn, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.validityPeriod
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: Acute Pharyngitis
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: Acute Tonsillitis
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: Comorbid Conditions for Respiratory Conditions
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: Competing Conditions for Respiratory Conditions
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: abatement, verificationStatus, onset, recordedDate, clinicalStatus
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, verificationStatus
Code Filter(s):
Path: code
ValueSet: Hospice Diagnosis
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
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
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
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
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
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
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
ErrorLevel In 0..1 string
SDE Sex Out 0..1 Coding
Numerator Out 0..* Encounter
Denominator Out 0..* Encounter
SDE Payer Out 0..* Resource
Initial Population Out 0..* Encounter
Encounter With Pharyngitis or Tonsillitis With Antibiotic Out 0..* Encounter
SDE Ethnicity Out 0..1 Resource
Denominator Exclusions Out 0..* Encounter
SDE Race Out 0..1 Resource
Generated using version 0.5.4 of the sample-content-ig Liquid templates