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
| Active as of 2026-01-16 |
{
"resourceType" : "Measure",
"id" : "CMS129FHIRProstCaBoneScanUse",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b style=\"color: maroon\">Exception generating Narrative: Unable to Parse HTML - node 'td' has unexpected content ' ' (last text = 'Risk Strata: Very Low/Low Risk: PSA \\' at line 479 column 69</b></p></div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "248153007",
"display" : "Male (finding)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "248152002",
"display" : "Female (finding)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed",
"display" : "confirmed"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "unconfirmed",
"display" : "unconfirmed"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "provisional",
"display" : "provisional"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "differential",
"display" : "differential"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "recurrence"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "relapse"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "254292007",
"display" : "Tumor staging (tumor staging)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228892002",
"display" : "American Joint Committee on Cancer cT1a (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228895000",
"display" : "American Joint Committee on Cancer cT1b (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228899006",
"display" : "American Joint Committee on Cancer cT1c (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228931008",
"display" : "American Joint Committee on Cancer cT2a (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "35266-6",
"display" : "Gleason score in Specimen Qualitative"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "433611000124109",
"display" : "Procedure reason record (record artifact)"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.sex() = '248153007' then \"Male (finding)\"\n when Patient.sex() = '248152002' then \"Female (finding)\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Prostate Cancer Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Prostate Cancer Diagnosis\":\n [ConditionProblemsHealthConcerns: \"Prostate Cancer\"] ProstateCancer\n where ProstateCancer.onset.toInterval ( ) overlaps day of \"Measurement Period\"\n and ProstateCancer.isVerified ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Bone Scan Study Performed"
},
{
"url" : "statement",
"valueString" : "define \"Bone Scan Study Performed\":\n [ObservationClinicalResult: \"Bone Scan\"] BoneScan\n with \"Prostate Cancer Diagnosis\" ActiveProstateCancer\n such that BoneScan.effective.toInterval ( ) starts after start of ActiveProstateCancer.prevalenceInterval ( )\n where BoneScan.effective.toInterval ( ) ends during day of \"Measurement Period\"\n and BoneScan.status in { 'final', 'amended', 'corrected' }"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n not exists \"Bone Scan Study Performed\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n exists \"Prostate Cancer Diagnosis\""
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "First Prostate Cancer Treatment during day of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"First Prostate Cancer Treatment during day of Measurement Period\":\n First([Procedure: \"Prostate Cancer Treatment\"] ProstateCancerTreatment\n where ProstateCancerTreatment.performed.toInterval ( ) ends during day of \"Measurement Period\"\n and ProstateCancerTreatment.status = 'completed'\n sort by start of performed.toInterval ( )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Most Recent Prostate Cancer Staging Tumor Size T1a to T2a"
},
{
"url" : "statement",
"valueString" : "define \"Most Recent Prostate Cancer Staging Tumor Size T1a to T2a\":\n ( Last(([ObservationClinicalResult: \"Tumor staging (tumor staging)\"] TumorStaging\n // TODO: determine feasibility of ObservationClinicalResult having basedOn reference to Condition\n // where exists(\"Prostate Cancer Diagnosis\" ActiveProstateCancer where TumorStaging.basedOn.references(ActiveProstateCancer))\n \n ) ProstateCancerStaging\n with \"First Prostate Cancer Treatment during day of Measurement Period\" FirstProstateCancerTreatment\n such that ProstateCancerStaging.effective.toInterval ( ) starts before start of FirstProstateCancerTreatment.performed.toInterval ( )\n and ProstateCancerStaging.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval ( )\n ) ) LastProstateCancerStaging\n where ( LastProstateCancerStaging.value ~ \"American Joint Committee on Cancer cT1a (qualifier value)\"\n or LastProstateCancerStaging.value ~ \"American Joint Committee on Cancer cT1b (qualifier value)\"\n or LastProstateCancerStaging.value ~ \"American Joint Committee on Cancer cT1c (qualifier value)\"\n or LastProstateCancerStaging.value ~ \"American Joint Committee on Cancer cT2a (qualifier value)\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Most Recent PSA Test Result is Low"
},
{
"url" : "statement",
"valueString" : "define \"Most Recent PSA Test Result is Low\":\n ( Last([LaboratoryResultObservation: \"Prostate Specific Antigen Test\"] PSATest\n with \"Most Recent Prostate Cancer Staging Tumor Size T1a to T2a\" MostRecentProstateCancerStaging\n such that PSATest.effective.toInterval ( ) starts before MostRecentProstateCancerStaging.effective.toInterval ( )\n and PSATest.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval ( )\n ) ) LastPSATest\n return LastPSATest.value as Quantity < 10 'ng/mL'"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Most Recent Gleason Score is Low"
},
{
"url" : "statement",
"valueString" : "define \"Most Recent Gleason Score is Low\":\n ( Last([ObservationClinicalResult: \"Gleason score in Specimen Qualitative\"] GleasonScore\n with \"First Prostate Cancer Treatment during day of Measurement Period\" FirstProstateCancerTreatment\n such that GleasonScore.effective.toInterval ( ) starts before start of FirstProstateCancerTreatment.performed.toInterval ( )\n and GleasonScore.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval ( )\n ) ) LastGleasonScore\n return LastGleasonScore.value as FHIR.integer <= 6"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\"\n and \"First Prostate Cancer Treatment during day of Measurement Period\" is not null\n and \"Most Recent Prostate Cancer Staging Tumor Size T1a to T2a\" is not null\n and \"Most Recent PSA Test Result is Low\"\n and \"Most Recent Gleason Score is Low\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [USQualityCore.Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n (Patient.ethnicity()) E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n (Patient.race()) R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Has Diagnosis of Pain related to Prostate Cancer"
},
{
"url" : "statement",
"valueString" : "define \"Has Diagnosis of Pain related to Prostate Cancer\":\n exists ( ( [ConditionProblemsHealthConcerns: \"Pain Warranting Further Investigation for Prostate Cancer\"]\n union [ConditionEncounterDiagnosis: \"Pain Warranting Further Investigation for Prostate Cancer\"] ) ProstateCancerPain\n with \"Prostate Cancer Diagnosis\" ActiveProstateCancer\n such that ProstateCancerPain.onset.toInterval ( ) starts after start of ActiveProstateCancer.prevalenceInterval ( )\n and ProstateCancerPain.isVerified ( )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Has Salvage Therapy Performed after Prostate Cancer Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Has Salvage Therapy Performed after Prostate Cancer Diagnosis\":\n exists ( [Procedure: \"Salvage Therapy\"] SalvageTherapy\n with \"Prostate Cancer Diagnosis\" ActiveProstateCancer\n such that SalvageTherapy.performed.toInterval ( ) starts after start of ActiveProstateCancer.onset.toInterval ( )\n and SalvageTherapy.status = 'completed'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Has Bone Scan Study Performed with Documented Reason"
},
{
"url" : "statement",
"valueString" : "define \"Has Bone Scan Study Performed with Documented Reason\":\n exists \"Bone Scan Study Performed\" BoneScanAfterDiagnosis\n where BoneScanAfterDiagnosis.value ~ \"Procedure reason record (record artifact)\""
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "Denominator Exceptions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exceptions\":\n \"Has Diagnosis of Pain related to Prostate Cancer\"\n or \"Has Salvage Therapy Performed after Prostate Cancer Diagnosis\"\n or \"Has Bone Scan Study Performed with Documented Reason\""
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value string): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "USCoreCommon"
},
{
"url" : "name",
"valueString" : "sex"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code"
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "ext"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n singleton from domainResource.exts(url)"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "exts"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n domainResource.extension E\n where E.url = url\n return E"
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "toInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n case\n when choice is FHIR.dateTime then\n Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n when choice is FHIR.Period then\n FHIRHelpers.ToInterval(choice as FHIR.Period)\n when choice is FHIR.instant then\n Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n when choice is FHIR.Age then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n when choice is FHIR.Range then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n when choice is FHIR.Timing then\n Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n when choice is FHIR.string then\n Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n else\n null as Interval<DateTime>\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToDateTime"
},
{
"url" : "statement",
"valueString" : "define function ToDateTime(value dateTime): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n if period is null then\n null\n else\n if period.\"start\" is null then\n Interval(period.\"start\".value, period.\"end\".value]\n else\n Interval[period.\"start\".value, period.\"end\".value]"
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToDateTime"
},
{
"url" : "statement",
"valueString" : "define function ToDateTime(value instant): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToDate"
},
{
"url" : "statement",
"valueString" : "define function ToDate(value date): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToQuantity"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n case\n when quantity is null then null\n when quantity.value is null then null\n when quantity.comparator is not null then\n Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n else\n Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCalendarUnit"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n case unit\n when 'ms' then 'millisecond'\n when 's' then 'second'\n when 'min' then 'minute'\n when 'h' then 'hour'\n when 'd' then 'day'\n when 'wk' then 'week'\n when 'mo' then 'month'\n when 'a' then 'year'\n else unit\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS129FHIRProstCaBoneScanUse"
},
{
"url" : "name",
"valueString" : "isVerified"
},
{
"url" : "statement",
"valueString" : "/*\n@note: When possible, this function should be migrated to QICoreCommon.\n@description: Returns true if the given Condition has a verification status of \"confirmed\", \"unconfirmed\", \"provisional\", or \"differential\"\n*/\n\n\ndefine fluent function isVerified(condition Choice<ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns>):\n condition.verificationStatus is not null implies ( condition.verificationStatus ~ Status.\"confirmed\"\n or condition.verificationStatus ~ Status.\"unconfirmed\"\n or condition.verificationStatus ~ Status.\"provisional\"\n or condition.verificationStatus ~ Status.\"differential\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToConcept"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCode"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "prevalenceInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return \n\t if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]"
},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "abatementInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n if condition.abatement is FHIR.dateTime then\n Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n else if condition.abatement is FHIR.Period then\n FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n else if condition.abatement is FHIR.string then\n Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n else if condition.abatement is FHIR.Age then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n else if condition.abatement is FHIR.Range then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n else if condition.abatement is FHIR.boolean then\n Interval[end of condition.onset.toInterval(), condition.recordedDate)\n else \n null"
},
{
"url" : "displaySequence",
"valueInteger" : 37
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value ObservationStatus): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 38
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value ProcedureStatus): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToInteger"
},
{
"url" : "statement",
"valueString" : "define function ToInteger(value integer): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "USCoreCommon"
},
{
"url" : "name",
"valueString" : "ethnicity"
},
{
"url" : "statement",
"valueString" : "define fluent function ethnicity(patient Patient):\n (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n return {\n ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n text: E.ext('text').value as FHIR.string\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 41
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "ext"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n singleton from element.exts(url)"
},
{
"url" : "displaySequence",
"valueInteger" : 42
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRCommon"
},
{
"url" : "name",
"valueString" : "exts"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n element.extension E\n where E.url = url\n return E"
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "USCoreCommon"
},
{
"url" : "name",
"valueString" : "race"
},
{
"url" : "statement",
"valueString" : "define fluent function race(patient Patient):\n (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n return {\n ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n text: E.ext('text').value as FHIR.string\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "USQualityCore model information",
"resource" : "https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild"
},
{
"type" : "depends-on",
"display" : "USCore model information",
"resource" : "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"
},
{
"type" : "depends-on",
"display" : "FHIR model information",
"resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
},
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "https://madie.cms.gov/Library/SupplementalDataElements|6.1.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"display" : "Library USCommon",
"resource" : "http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot"
},
{
"type" : "depends-on",
"display" : "Library FHIRCommon",
"resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0"
},
{
"type" : "depends-on",
"display" : "Library Status",
"resource" : "https://madie.cms.gov/Library/Status|2.1.000"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system ConditionVerificationStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
},
{
"type" : "depends-on",
"display" : "Code system ConditionClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
},
{
"type" : "depends-on",
"display" : "Code system LOINC",
"resource" : "http://loinc.org"
},
{
"type" : "depends-on",
"display" : "Value set Bone Scan",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.320"
},
{
"type" : "depends-on",
"display" : "Value set Prostate Cancer",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.319"
},
{
"type" : "depends-on",
"display" : "Value set Prostate Cancer Treatment",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.398"
},
{
"type" : "depends-on",
"display" : "Value set Prostate Specific Antigen Test",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.401"
},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
},
{
"type" : "depends-on",
"display" : "Value set Pain Warranting Further Investigation for Prostate Cancer",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.451"
},
{
"type" : "depends-on",
"display" : "Value set Salvage Therapy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.399"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
},
{
"name" : "Denominator Exceptions",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
}
],
"dataRequirement" : [
{
"type" : "Patient",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient"
],
"mustSupport" : [
"ombCategory",
"detailed",
"text"
]
},
{
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
],
"mustSupport" : [
"birthDate"
]
},
{
"type" : "Condition",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"
],
"mustSupport" : [
"code"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.451"
}
]
},
{
"extension" : [
{
"extension" : [
{
"url" : "targetId",
"valueString" : "1624"
},
{
"url" : "targetProperty",
"valueString" : "performed"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-relatedRequirement"
}
],
"type" : "Condition",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"
],
"mustSupport" : [
"code",
"onset"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.319"
}
]
},
{
"type" : "Condition",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"
],
"mustSupport" : [
"code",
"onset"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.319"
}
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"abatement",
"onset",
"recordedDate",
"clinicalStatus"
]
},
{
"type" : "Observation",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"
],
"mustSupport" : [
"code",
"effective",
"status",
"value"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.320"
}
],
"dateFilter" : [
{
"path" : "effective",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"type" : "Observation",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"
],
"mustSupport" : [
"code",
"value",
"effective"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "254292007",
"display" : "Tumor staging (tumor staging)"
}
]
}
]
},
{
"id" : "670",
"type" : "Observation",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"
],
"mustSupport" : [
"code",
"effective",
"status",
"value"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "254292007",
"display" : "Tumor staging (tumor staging)"
}
]
}
]
},
{
"id" : "1162",
"type" : "Observation",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"
],
"mustSupport" : [
"code",
"effective",
"status",
"value"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://loinc.org",
"code" : "35266-6",
"display" : "Gleason score in Specimen Qualitative"
}
]
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.398"
},
{
"path" : "status",
"code" : [
{
"code" : "completed"
}
]
}
],
"dateFilter" : [
{
"path" : "performed",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"extension" : [
{
"extension" : [
{
"url" : "targetId",
"valueString" : "670"
},
{
"url" : "targetProperty",
"valueString" : "effective"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-relatedRequirement"
}
],
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.398"
},
{
"path" : "status",
"code" : [
{
"code" : "completed"
}
]
}
],
"dateFilter" : [
{
"path" : "performed",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"extension" : [
{
"extension" : [
{
"url" : "targetId",
"valueString" : "1162"
},
{
"url" : "targetProperty",
"valueString" : "effective"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-relatedRequirement"
}
],
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.398"
},
{
"path" : "status",
"code" : [
{
"code" : "completed"
}
]
}
],
"dateFilter" : [
{
"path" : "performed",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"id" : "1624",
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.399"
},
{
"path" : "status",
"code" : [
{
"code" : "completed"
}
]
}
]
},
{
"type" : "Observation",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"
],
"mustSupport" : [
"code",
"effective",
"status",
"value"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.401"
}
]
},
{
"type" : "Coverage",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage"
],
"mustSupport" : [
"type",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
},
{
"type" : "Condition",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"
],
"mustSupport" : [
"code"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.451"
}
]
}
]
}
],
"extension" : [
{
"id" : "supplementalDataGuidance",
"extension" : [
{
"url" : "guidance",
"valueString" : "<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>"
},
{
"url" : "usage",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data",
"display" : "Supplemental Data"
}
],
"text" : "Supplemental Data Guidance"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Bone scan"
},
{
"url" : "definition",
"valueMarkdown" : "Bone scan refers to the conventional technetium-99m-methyl diphosphonate bone scan as well as 18F-sodium fluoride or prostate-specific membrane antigen (PSMA) PET/CT scan\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "External beam radiotherapy "
},
{
"url" : "definition",
"valueMarkdown" : "External beam radiotherapy refers to 3D conformal radiation therapy, intensity modulated radiation therapy, stereotactic body radiotherapy, and proton beam therapy\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Risk Strata: High/Very High Risk"
},
{
"url" : "definition",
"valueMarkdown" : "PSA \\> 20 ng/mL; OR Gleason score 8 to 10/Gleason grade group 4-5; OR clinically localized stage T3 to T4 (adapted from the National Comprehensive Cancer Network, 2018)\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Risk Strata: Intermediate Risk"
},
{
"url" : "definition",
"valueMarkdown" : "PSA 10 to 20 ng/mL; OR Gleason score 7/Gleason grade group 2-3; OR clinical stage T2b to T2c\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Risk Strata: Very Low/Low Risk"
},
{
"url" : "definition",
"valueMarkdown" : "PSA \\< 10 ng/mL; AND Gleason score 6 or less/Gleason grade group 1; AND clinical stage T1 to T2a\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
"valueReference" : {
"reference" : "Device/cqf-tooling"
}
},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
"valueCanonical" : "#effective-data-requirements"
}
],
"url" : "https://madie.cms.gov/Measure/CMS129FHIRProstCaBoneScanUse",
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "short-name",
"display" : "Short Name"
}
]
},
"system" : "https://madie.cms.gov/measure/shortName",
"value" : "CMS129FHIR"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "version-independent",
"display" : "Version Independent"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:a9fa2b95-f5f7-4ff4-931c-b47df9d6371f"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "version-specific",
"display" : "Version Specific"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:2bdfa3ee-eaa5-42ae-8483-a71dc6d3521f"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "publisher",
"display" : "Publisher"
}
]
},
"system" : "https://madie.cms.gov/measure/cmsId",
"value" : "129FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "1.0.000",
"name" : "CMS129FHIRProstCaBoneScanUse",
"title" : "Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer PatientsFHIR\n",
"status" : "active",
"experimental" : false,
"date" : "2026-01-16T18:18:12+00:00",
"publisher" : "Centers for Medicare & Medicaid Services (CMS)",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "https://www.cms.gov/"
}
]
}
],
"description" : "Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer\n",
"usage" : "A higher score indicates appropriate treatment of patients with prostate cancer at low (or very low) risk of recurrence. Only patients with prostate cancer with low (or very low) risk of recurrence will be counted in the performance denominator of this measure.\n\nPSA test results reported in units other than ng/mL should be converted to ng/mL for reporting of this measure.\n\nIn 2022, the American Urological Association published guidance recommending that clinicians not perform bone scan in asymptomatic patients with low or favorable intermediate risk prostate cancer. However, this quality measure remains focused on patients with low (or very low) risk of recurrence.\n\nThis eCQM is a patient-based measure.\n\nTelehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS 129v15. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n",
"copyright" : "This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare \\& Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications.\n\nLimited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.\n\nAIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2023 World Health Organization. All Rights Reserved.\n",
"effectivePeriod" : {
"start" : "2026-01-01",
"end" : "2026-12-31"
},
"author" : [
{
"name" : "American Institutes for Research (AIR)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.air.org"
}
]
}
],
"relatedArtifact" : [
{
"type" : "citation",
"citation" : "American Society of Clinical Oncology (2021) American Society of Clinical Oncology Choosing Wisely; Last Reviewed 2021. Retrieved from https://www.asco.org/news-initiatives/current-initiatives/cancer-care-initiatives/value-cancer-care/choosing-wisely\n"
},
{
"type" : "citation",
"citation" : "American Urological Association. (2013). Five Things Physicians and Patients Should Question. Choosing Wisely. https://www.auanet.org/documents/practices-resources/quality/choosing-wisely/AUA-Choosing-Wisely-15-Things.pdf\n"
},
{
"type" : "citation",
"citation" : "Eastham JA, Auffenberg GB, Barocas DA, et al. (2022) Clinically localized prostate cancer: AUA/ASTRO guideline, part I: introduction, risk assessment, staging, and risk-based management. J Urol, 208(1):10-18. doi: 10.1097/JU.0000000000002757.\n"
},
{
"type" : "citation",
"citation" : "Falchook, A. D., Hendrix, L. H., \\& Chen, R. C. (2015). Guideline-discordant use of imaging during work-up of newly diagnosed prostate cancer. Journal of Oncology Practice, 11(2), e239-e246. doi:10.1200/jop.2014.001818\n"
},
{
"type" : "citation",
"citation" : "National Comprehensive Cancer Network (2024) NCCN Clinical Practice Guidelines in Oncology Prostate Cancer. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf\n"
}
],
"library" : [
"https://madie.cms.gov/Library/CMS129FHIRProstCaBoneScanUse"
],
"disclaimer" : "The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.\n\nTHE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\].\n",
"rationale" : "Multiple studies have indicated that a bone scan is not clinically necessary for staging prostate cancer in patients with a low (or very low) risk of recurrence and receiving primary therapy. For patients who are categorized as low risk, bone scans are unlikely to identify their disease. Furthermore, bone scans are not necessary for low risk patients who have no history of bony involvement or if the clinical examination suggests no bony involvement. Less than 1% of low risk patients are at risk of metastatic disease.\n\nWhile clinical practice guidelines do not recommend bone scans in low risk prostate cancer patients, overuse is still common. An analysis of prostate cancer patients in the Surveillance, Epidemiology and End Results Medicare database diagnosed from 2004-2007 found that 43% of patients for whom a bone scan was not recommended received it (Falchook, Hendrix, \\& Chen, 2015). The analysis also found that the use of bone scans in low risk patients leads to an annual cost of $4 million dollars to Medicare. The overuse of bone scan imaging for low risk prostate cancer patients is a concept included on the American Urological Association's (AUA) list in the Choosing Wisely Initiative as a means to promote adherence to evidence-based imaging practices and to reduce health care dollars wasted (AUA, 2019). This measure is intended to promote adherence to evidence-based imaging practices, lessen the financial burden of unnecessary imaging, and ultimately to improve the quality of care for prostate cancer patients in the United States.\n",
"clinicalRecommendationStatement" : "For symptomatic patients and/or those with a life expectancy of greater than 5 years, bone and soft tissue imaging is appropriate for patients with unfavorable intermediate-risk, high-risk, and very-high-risk prostate cancer (National Comprehensive Cancer Network, 2024) (Evidence Level: Category 2A).\n\nClinicians should not routinely perform abdominopelvic computed tomography (CT) scan or bone scan in asymptomatic patients with low- or intermediate-risk prostate cancer (Eastham, 2022) (Expert Opinion).\n\nDon't perform PET, CT, and radionuclide bone scans, or newer imaging scans in the staging of early prostate cancer at low risk for metastasis (ASCO, 2021).\n",
"group" : [
{
"id" : "Group_1",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process",
"display" : "Process"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
}
}
],
"description" : "Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer\n",
"population" : [
{
"id" : "InitialPopulation_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "All patients, regardless of age, with a diagnosis of prostate cancer\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "Denominator_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "Numerator_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who did not have a bone scan performed after diagnosis of prostate cancer and before the end of the measurement period\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "DenominatorException_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Documentation of reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, or other medical reasons)\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}