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/CMS69FHIRPCSBMIScreenAndFollowUp#effective-data-requirements Version: 1.0.000
Active Responsible: Centers for Medicare & Medicaid Services (CMS) Computable Name: EffectiveDataRequirements
Metadata
Type http://terminology.hl7.org/CodeSystem/library-type#module-definition
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: extension
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate.value
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Follow Up for Above Normal BMI
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: Medications for Above Normal BMI
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Overweight or Obese
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Overweight or Obese
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, reasonCode, performed
Code Filter(s):
Path: code
ValueSet: Follow Up for Above Normal BMI
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Follow Up for Below Normal BMI
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Referrals Where Weight Assessment May Occur
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: Medications for Below Normal BMI
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication.reference.value
Data Requirement Type: Medication
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
Must Support Elements: id.value, code
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Underweight
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Underweight
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, reasonCode, status, status.value, performed
Code Filter(s):
Path: code
ValueSet: Follow Up for Below Normal BMI
Data Requirement Type: Observation
Profile(s): US Core BMI Profile
Must Support Elements: value, effective
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period
Code Filter(s):
Path: type
ValueSet: Encounter Inpatient
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Hospice Encounter
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, value, effective
Code Filter(s):
Path: code
Code(s): LOINC: 45755-6 (Hospice care [Minimum Data Set])
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code, authoredOn, authoredOn.value
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hospice Diagnosis
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hospice Diagnosis
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, effective
Code Filter(s):
Path: code
Code(s): LOINC: 71007-9 (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Palliative Care Diagnosis
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Palliative Care Diagnosis
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Palliative Care Encounter
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Palliative Care Intervention
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Pregnancy Obstetric or Maternal Diagnoses
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Pregnancy Obstetric or Maternal Diagnoses
Data Requirement Type: Observation
Profile(s): US Core Observation Pregnancy Status Profile
Must Support Elements: effective, effective.value, status, status.value, value
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Referrals Where Weight Assessment May Occur
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Follow Up for Above Normal BMI
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Follow Up for Below Normal BMI
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: Medications for Above Normal BMI
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: Medications for Below Normal BMI
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): LOINC: 39156-5 (Body mass index (BMI) [Ratio])
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled
Must Support Elements: code
Code Filter(s):
Path: code
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, class, status, status.value
Code Filter(s):
Path: type
ValueSet: Encounter to Evaluate BMI
Data Requirement Type: Coverage
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url, extension
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
Denominator Exceptions Out 0..1 boolean
Citations and References
Dependency Description: Library SDE
Resource: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library Status
Resource: https://madie.cms.gov/Library/Status|1.15.000
Canonical URL: https://madie.cms.gov/Library/Status|1.15.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library QICoreCommon
Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library Hospice
Resource: https://madie.cms.gov/Library/Hospice|6.18.000
Canonical URL: https://madie.cms.gov/Library/Hospice|6.18.000
Dependency Description: Library Status
Resource: https://madie.cms.gov/Library/Status|1.15.000
Canonical URL: https://madie.cms.gov/Library/Status|1.15.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library QICoreCommon
Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library PalliativeCare
Resource: https://madie.cms.gov/Library/PalliativeCare|1.18.000
Canonical URL: https://madie.cms.gov/Library/PalliativeCare|1.18.000
Dependency Description: Library Status
Resource: https://madie.cms.gov/Library/Status|1.15.000
Canonical URL: https://madie.cms.gov/Library/Status|1.15.000
Dependency Description: Library QICoreCommon
Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Dependency Description: Library FHIRHelpers
Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Dependency Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Dependency Description: Code system USCoreConditionCategoryExtensionCodes
Resource: US Core Condition Category Extension Codes
Canonical URL: http://hl7.org/fhir/us/core/CodeSystem/condition-category
Dependency Description: Code system ActCode
Resource: ActCode
Canonical URL: http://terminology.hl7.org/CodeSystem/v3-ActCode
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 ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status
Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Value set Follow Up for Above Normal BMI
Resource: Follow Up for Above Normal BMI
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
Dependency Description: Value set Referrals Where Weight Assessment May Occur
Resource: Referrals Where Weight Assessment May Occur
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
Dependency Description: Value set Medications for Above Normal BMI
Resource: Medications for Above Normal BMI
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
Dependency Description: Value set Overweight or Obese
Resource: Overweight or Obese
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502
Dependency Description: Value set Follow Up for Below Normal BMI
Resource: Follow Up for Below Normal BMI
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
Dependency Description: Value set Medications for Below Normal BMI
Resource: Medications for Below Normal BMI
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
Dependency Description: Value set Underweight
Resource: Underweight
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563
Dependency Description: Value set Encounter to Evaluate BMI
Resource: Encounter to Evaluate BMI
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
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 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
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
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
Dependency Description: Value set Pregnancy or Other Related Diagnoses
Resource: Pregnancy Obstetric or Maternal Diagnoses
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1623
Dependency Description: Value set Medical Reason
Resource: Medical Reason
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007
Dependency Description: Value set Patient Declined
Resource: Patient Declined
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582
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