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/CMS56FHIRFuncStatHipReplacement#effective-data-requirements Version: 1.0.000
Active Responsible: Centers for Medicare & Medicaid Services (CMS) 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: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
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: Value set Primary THA Procedure
Resource: Primary THA Procedure
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1006
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 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 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 Lower Body Fractures Excluding Ankle and Foot
Resource: Lower Body Fractures Excluding Ankle and Foot
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1178
Dependency Description: Value set Partial Arthroplasty of Hip
Resource: Partial Arthroplasty of Hip
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1184
Dependency Description: Value set Removal, Revision and Supplement Procedures of the Lower Body and Spine
Resource: Removal, Revision and Supplement Procedures of the Lower Body and Spine
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1189
Dependency Description: Value set Malignant Neoplasms of Lower and Unspecified Limbs
Resource: Malignant Neoplasms of Lower and Unspecified Limbs
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1180
Dependency Description: Value set Mechanical Complications Excluding Upper Body
Resource: Mechanical Complications Excluding Upper Body
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1182
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, deceased
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: birthDate
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: Partial Arthroplasty of Hip
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: Removal, Revision and Supplement Procedures of the Lower Body and Spine
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, id, performed, status
Code Filter(s):
Path: code
ValueSet: Primary THA Procedure
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, id, status
Code Filter(s):
Path: code
ValueSet: Primary THA Procedure
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: Primary THA Procedure
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: 72093-8 (Quality of life score [HOOS])
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: 72094-6 (Sport-recreation score [HOOS])
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: 72095-3 (Activities of daily living score [HOOS])
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: 72096-1 (Symptoms score [HOOS])
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: 72097-9 (Pain score [HOOS])
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, status, effective
Code Filter(s):
Path: code
Code(s): LOINC: 82323-7 (Total interval score [HOOSJR])
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: 71969-0 (PROMIS-10 Global Mental Health (GMH) score T-score)
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: 71971-6 (PROMIS-10 Global Physical Health (GPH) score T-score)
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: 72026-8 (VR-12 Mental component summary (MCS) score - oblique method T-score)
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: 72025-0 (VR-12 Physical component summary (PCS) score - oblique method T-score)
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: value, status
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: 72028-4 (VR-12 Mental component summary (MCS) score - orthogonal method T-score)
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: 72027-6 (VR-12 Physical component summary (PCS) score - orthogonal method T-score)
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: 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: Outpatient Consultation
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: 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: 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: 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: 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
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: 702956004 (Severe cognitive impairment (finding))
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: Lower Body Fractures Excluding Ankle and Foot
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: Malignant Neoplasms of Lower and Unspecified Limbs
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: Mechanical Complications Excluding Upper Body
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: 702956004 (Severe cognitive impairment (finding))
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: Lower Body Fractures Excluding Ankle and Foot
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: Malignant Neoplasms of Lower and Unspecified Limbs
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: Mechanical Complications Excluding Upper Body
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
SDE Sex Out 0..1 Coding
Numerator Out 0..1 boolean
Denominator Out 0..1 boolean
SDE Payer Out 0..* Resource
Initial Population Out 0..1 boolean
SDE Ethnicity Out 0..1 Resource
Denominator Exclusions Out 0..1 boolean
SDE Race Out 0..1 Resource
Generated using version 0.5.4 of the sample-content-ig Liquid templates