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

Measure: Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR

Official URL: https://madie.cms.gov/Measure/CMS190FHIRVTEProphylaxisICU Version: 1.0.000
Active as of 2026-01-16 Responsible: The Joint Commission Computable Name: CMS190FHIRVTEProphylaxisICU
Other Identifiers: Short Name: CMS190FHIR (use: usual, ), UUID:693f0836-228e-43cc-ac71-53388e5dc010 (use: official, ), UUID:b7f93612-84e8-4641-b092-3986da8bb608 (use: official, ), Publisher: 190FHIR (use: official, )

Copyright/Legal: Measure specifications are in the Public Domain.

LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.

This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis on the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer) or have documentation why no VTE prophylaxis was given between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer)

Metadata
Title Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR
Version 1.0.000
Short Name CMS190FHIR
GUID (Version Independent) urn:uuid:693f0836-228e-43cc-ac71-53388e5dc010
GUID (Version Specific) urn:uuid:b7f93612-84e8-4641-b092-3986da8bb608
CMS Identifier 190FHIR
Effective Period 2026-01-01 through 2026-12-31
Steward (Publisher) The Joint Commission
Developer The Joint Commission
Description

This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis on the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer) or have documentation why no VTE prophylaxis was given between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer)
Copyright

Measure specifications are in the Public Domain.

LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.
Disclaimer

These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.
Rationale

Venous Thromboembolism (VTE) is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020).

Almost all hospitalized patients have at least one risk factor for VTE, and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired deep-vein thrombosis (DVT) is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008).

Commonly, criteria for admission to the Intensive Care Unit (ICU) itself puts patients at an increased risk for developing VTE and subsequent increased risk of morbidity from pulmonary embolism (PE). Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts et al., 2004).

American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. (NOTE: Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.)
Clinical Recommendation Statement

Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.
Citation

Anderson, D. R., Morgano, G. P., Bennett, C., Dentali, F., Francis, C. W., Garcia, D. A., . . . Dahm, P. (2019). American Society of Hematology 2019 guidelines for management of venous thromboembolism: Prevention of venous thromboembolism in surgical hospitalized patients. Blood Advances, 3(23), 3898-3944. doi: 10.1182/bloodadvances.2019000975.
Citation

Geerts, W. H., Bergqvist, D., Pineo, G. F., et al. (2008). Prevention of venous thromboembolism: The Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 133, 381S-453S.
Citation

Geerts, W. H., Pineo, G. F., Heit, J. A., et al. (2004). Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 126(3 Suppl.), 338S-400S.
Citation

Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012). Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S.
Citation

Kearon, C., Akl, E. A., Comerota, A. J., et al. (2012, February). Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), e419S-e494S.
Citation

Shojania, K. G., Duncan, B. W., McDonald, D. M., et al. (eds.). (2001). Making health care safer: A critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43. Rockville, MD: Agency for Healthcare Research and Quality.
Guidance (Usage) The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project (CDC, 2022). An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the medical doctor, advanced practice registered nurse, physician assistant, or pharmacist and linked with VTE prophylaxis. The only exception is patient refusal may be documented by a nurse. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed." This measure does not require the use of a specific risk assessment model or tool (e.g., Caprini, Padua, and IMPROVE) to determine VTE risk. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. Inpatient hospitalizations for patients with a principal procedure of selected surgeries are excluded from the measure's denominator. Selected surgeries include general surgery, gynecological surgery, hip fracture surgery, hip/knee replacement surgery, intracranial neurosurgery, and urological surgery. Inpatient hospitalizations for patients administered apixaban or edoxaban, medications included in the "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" value set, would be counted in the numerator population only when the patients also have either a prior or present diagnosis of atrial fibrillation, a prior diagnosis of VTE, or a prior or present procedure of hip/knee replacement surgery. This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS190v14. 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)
Measure Group (Rate) (ID: Group_1)
Basis Encounter
Scoring Proportion
Improvement Notation Increased score indicates improvement
Type Process
Rate Aggregation None
Initial Population ID: InitialPopulation_1
Description:

Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period

Criteria: Initial Population
Denominator ID: Denominator_1
Description:

Inpatient hospitalizations for patients directly admitted or transferred to ICU during the hospitalization

Criteria: Denominator
Denominator Exclusion ID: DenominatorExclusion_1
Description:

- Inpatient hospitalizations for patients who have a hospital length of stay (LOS) less than 2 days - Inpatient hospitalizations for patients with a principal procedure of selected surgeries that end the day of or the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day after ICU admission or transfer

Criteria: Denominator Exclusions
Denominator Exception ID: DenominatorException_1
Description:

Inpatient hospitalizations for patients with ICU LOS less than one day

Criteria: Denominator Exceptions
Numerator ID: Numerator_1
Description:

Inpatient hospitalizations for patients who received VTE prophylaxis: - the day of or the day after ICU admission (or transfer) - the day of or the day after surgery end date (for surgeries that end the day after ICU admission or transfer) Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given: - between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) - the day of or the day after surgery end date (for surgeries that end the day after ICU admission or transfer)

Criteria: Numerator
<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: SDE Ethnicity
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: SDE Payer
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: SDE Race
Logic Definition: SDE Race
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: SDE Sex
Logic Definition: SDE Sex
Measure Logic
Primary Library https://madie.cms.gov/Library/CMS190FHIRVTEProphylaxisICU
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Parameters
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population 
define "Initial Population":
  VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions"
Definition
Denominator 
define "Denominator":
  "Encounter With ICU Location"
Definition
Denominator Exclusion 
define "Denominator Exclusions":
  "Encounter With ICU Location And Encounter Less Than 2 Days"
    union "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery"
    union "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay"
    union "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure"
Definition
Denominator Exception 
define "Denominator Exceptions":
  "Encounter With First ICU Location Stay Less Than 1 Day"
Definition
Numerator 
define "Numerator":
  "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure"
    union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure"
        intersect ( "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE"
            union "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery"
        )
    )
    union "Encounter With Low Risk For VTE Or Anticoagulant Administered"
    union "Encounter With No VTE Prophylaxis Due To Medical Reason"
    union "Encounter With No VTE Prophylaxis Due To Patient Refusal"
Definition
Logic Definitions
Logic Definition Library Name: SupplementalDataElements 
define "SDE Sex":
  case
    when Patient.sex() = '248153007' then "Male (finding)"
    when Patient.sex() = '248152002' then "Female (finding)"
    else null
  end
Logic Definition Library Name: SupplementalDataElements 
define "SDE Payer":
  [USQualityCore.Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }
Logic Definition Library Name: SupplementalDataElements 
define "SDE Ethnicity":
  (Patient.ethnicity()) E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }
Logic Definition Library Name: SupplementalDataElements 
define "SDE Race":
  (Patient.race()) R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }
Logic Definition Library Name: TJCOverall 
define fluent function calendarDayOfOrDayAfter(StartValue DateTime):
  Interval [date from (StartValue), date from (StartValue) + 1 day]
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "SDE Sex":
  SDE."SDE Sex"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With ICU Location":
  VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions" QualifyingEncounter
    where exists ( QualifyingEncounter.location Location
        where Location.location.getLocation ( ).type in "Intensive Care Unit"
          and Location.period during QualifyingEncounter.period
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Pharmacological Or Mechanical VTE Prophylaxis Received":
  ( ["MedicationAdministration": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
      where VTEMedication.status = 'completed'
        and VTEMedication.dosage.route in "Subcutaneous route"
  )
    union ( ["MedicationAdministration": "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH
        where LMWH.status = 'completed'
    )
    union ( ["MedicationAdministration": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa
        where FactorXa.status = 'completed'
    )
    union ( ["MedicationAdministration": "Warfarin"] WarfarinAdm
        where WarfarinAdm.status = 'completed'
    )
    union ( ["MedicationAdministration": "Rivaroxaban for VTE Prophylaxis"] Rivaroxaban
        where Rivaroxaban.status = 'completed'
    )
    union ( ( ["Procedure": "Application of Intermittent Pneumatic Compression Devices"]
        union ["Procedure": "Application of Venous Foot Pumps"]
        union ["Procedure": "Application of Graduated Compression Stockings"] ) DeviceApplied
        where DeviceApplied.status = 'completed'
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure":
  ( "Encounter With ICU Location" QualifyingEncounterICU
      with "Pharmacological Or Mechanical VTE Prophylaxis Received" VTEProphylaxis
        such that start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of QualifyingEncounterICU.startOfFirstICU ( ).calendarDayOfOrDayAfter ( )
  )
    union ( from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "Pharmacological Or Mechanical VTE Prophylaxis Received" VTEProphylaxis
        where AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure":
  ( "Encounter With ICU Location" QualifyingEncounterICU
      with ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
        such that FactorXaMedication.status = 'completed'
          and FactorXaMedication.effective.toInterval ( ) starts during day of QualifyingEncounterICU.startOfFirstICU ( ).calendarDayOfOrDayAfter ( )
  )
    union ( from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
        where FactorXaMedication.status = 'completed'
          and AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE":
  ( "Encounter With ICU Location" QualifyingEncounterICU
      with ["ConditionProblemsHealthConcerns": "Atrial Fibrillation or Flutter"] AtrialFibrillation
        such that AtrialFibrillation.verificationStatus is not null implies ( AtrialFibrillation.verificationStatus !~ Status."refuted"
            and AtrialFibrillation.verificationStatus !~ Status."entered-in-error"
        )
          and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounterICU.period
  )
    union ( "Encounter With ICU Location" QualifyingEncounterICU
        where QualifyingEncounterICU.hasEncDiagnosisOf ( "Atrial Fibrillation or Flutter" )
    )
    union ( "Encounter With ICU Location" QualifyingEncounterICU
        with ["ConditionProblemsHealthConcerns": "Venous Thromboembolism"] VTEDiagnosis
          such that ( VTEDiagnosis.clinicalStatus ~ Status."inactive"
              or VTEDiagnosis.clinicalStatus ~ Status."remission"
              or VTEDiagnosis.clinicalStatus ~ Status."resolved"
          )
            and VTEDiagnosis.verificationStatus is not null implies ( VTEDiagnosis.verificationStatus !~ Status."refuted"
              and VTEDiagnosis.verificationStatus !~ Status."entered-in-error"
          )
            and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounterICU.period
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery":
  "Encounter With ICU Location" QualifyingEncounterICU
    with ( ["Procedure": "Hip Replacement Surgery"]
      union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure
      such that HipKneeProcedure.status = 'completed'
        and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounterICU.period
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Low Risk Indicator For VTE":
  ( ["SimpleObservation": "Risk for venous thromboembolism"] VTERiskAssessment
      where VTERiskAssessment.value as CodeableConcept in "Low Risk"
        and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }
      return {
        id: VTERiskAssessment.id,
        LowRiskDatetime: VTERiskAssessment.effective.earliest ( )
      }
  )
    union ( ["LaboratoryResultObservation": "INR"] INRLabTest
        where INRLabTest.value as Quantity > 3.0
          and INRLabTest.status in { 'final', 'amended', 'corrected' }
        return {
          id: INRLabTest.id,
          LowRiskDatetime: INRLabTest.issued
        }
    )
    union ( ( ( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin
          where UnfractionatedHeparin.dosage.route in "Intravenous route"
      )
        union ["MedicationAdministration": "Direct Thrombin Inhibitor"]
        union ["MedicationAdministration": "Glycoprotein IIb IIIa Inhibitors"] ) AnticoagulantMedication
        where AnticoagulantMedication.status = 'completed'
        return {
          id: AnticoagulantMedication.id,
          LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )
        }
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Low Risk For VTE Or Anticoagulant Administered From Day Of Start Of Hospitalization To Day After First ICU Stay":
  "Encounter With ICU Location" QualifyingEncounterICU
    with "Low Risk Indicator For VTE" LowRiskForVTE
      such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Low Risk For VTE Or Anticoagulant Administered On Day Of Or Day After Procedure":
  from
    "Encounter With ICU Location" QualifyingEncounterICU,
    ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
    "Low Risk Indicator For VTE" LowRiskForVTE
    where AnesthesiaProcedure.status = 'completed'
      and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
      and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
    return QualifyingEncounterICU
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Low Risk For VTE Or Anticoagulant Administered":
  "Low Risk For VTE Or Anticoagulant Administered From Day Of Start Of Hospitalization To Day After First ICU Stay"
    union "Low Risk For VTE Or Anticoagulant Administered On Day Of Or Day After Procedure"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No VTE Prophylaxis Medication Administered Or Ordered":
  ( ( [MedicationAdministrationNotDone: "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
      union [MedicationAdministrationNotDone: "Low Molecular Weight Heparin for VTE Prophylaxis"]
      union [MedicationAdministrationNotDone: "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
      union [MedicationAdministrationNotDone: "Warfarin"]
      union [MedicationAdministrationNotDone: "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationAdm
      return {
        id: NoMedicationAdm.id,
        medicationStatusReason: NoMedicationAdm.statusReason,
        authoredOn: NoMedicationAdm.effective
      }
  )
    union ( ( ["MedicationNotRequested": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
        union ["MedicationNotRequested": "Low Molecular Weight Heparin for VTE Prophylaxis"]
        union ["MedicationNotRequested": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
        union ["MedicationNotRequested": "Warfarin"]
        union ["MedicationNotRequested": "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationOrder
        where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and NoMedicationOrder.status in { 'active', 'completed' }
        return {
          id: NoMedicationOrder.id,
          medicationStatusReason: NoMedicationOrder.reasonCode,
          authoredOn: NoMedicationOrder.authoredOn
        }
    )
    union ( from
        ( ["MedicationRequest": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
          union ["MedicationRequest": "Low Molecular Weight Heparin for VTE Prophylaxis"]
          union ["MedicationRequest": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
          union ["MedicationRequest": "Warfarin"]
          union ["MedicationRequest": "Rivaroxaban for VTE Prophylaxis"] ) MedicationOrderReject,
        [TaskRejected] T
        where T.focus.references ( MedicationOrderReject )
          and T.code ~ USQualityCoreCommon."Fulfill"
          and MedicationOrderReject.status = 'active'
        return {
          id: MedicationOrderReject.id,
          medicationStatusReason: { T.statusReason },
          authoredOn: MedicationOrderReject.authoredOn
        }
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No VTE Prophylaxis Medication Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay":
  "Encounter With ICU Location" QualifyingEncounterICU
    with "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
      such that NoVTEMedication.medicationStatusReason in "Medical Reason For Not Providing Treatment"
        and NoVTEMedication.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No Mechanical VTE Prophylaxis Performed Or Ordered":
  ( ( [ServiceNotRequested: "Venous foot pumps"]
      union [ServiceNotRequested: "Intermittent pneumatic compression devices"]
      union [ServiceNotRequested: "Graduated compression stockings"] ) DeviceNotOrder
      where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
      return {
        id: DeviceNotOrder.id,
        requestStatusReason: DeviceNotOrder.reasonRefused ( ),
        authoredOn: DeviceNotOrder.authoredOn
      }
  )
    union ( from
        ( [ServiceRequest: "Venous foot pumps"]
          union [ServiceRequest: "Intermittent pneumatic compression devices"]
          union [ServiceRequest: "Graduated compression stockings"] ) DeviceOrderReject,
        [TaskRejected] T
        where DeviceOrderReject.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and DeviceOrderReject.status = 'active'
          and T.focus.references ( DeviceOrderReject )
          and T.code ~ USQualityCoreCommon."Fulfill"
        return {
          id: DeviceOrderReject.id,
          requestStatusReason: T.statusReason,
          authoredOn: DeviceOrderReject.authoredOn
        }
    )
    union ( ( [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices"]
        union [ProcedureNotDone: "Application of Venous Foot Pumps"]
        union [ProcedureNotDone: "Application of Graduated Compression Stockings"] ) DeviceNotApplied
        let DeviceNotDoneTiming: DeviceNotApplied.performed
        return {
          id: DeviceNotApplied.id,
          requestStatusReason: DeviceNotApplied.statusReason,
          authoredOn: DeviceNotDoneTiming
        }
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No Mechanical VTE Prophylaxis Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay":
  "Encounter With ICU Location" QualifyingEncounterICU
    with "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
      such that NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
        and NoVTEDevice.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No VTE Prophylaxis Medication Due To Medical Reason On Day Of Or Day After Procedure":
  from
    "Encounter With ICU Location" QualifyingEncounterICU,
    ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
    "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
    where NoVTEMedication.medicationStatusReason in "Medical Reason For Not Providing Treatment"
      and AnesthesiaProcedure.status = 'completed'
      and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
      and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
    return QualifyingEncounterICU
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No Mechanical VTE Prophylaxis Due To Medical Reason On Day Of Or Day After Procedure":
  from
    "Encounter With ICU Location" QualifyingEncounterICU,
    ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
    "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
    where NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
      and AnesthesiaProcedure.status = 'completed'
      and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
      and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
    return QualifyingEncounterICU
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With No VTE Prophylaxis Due To Medical Reason":
  ( "No VTE Prophylaxis Medication Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay"
      intersect "No Mechanical VTE Prophylaxis Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay"
  )
    union ( "No VTE Prophylaxis Medication Due To Medical Reason On Day Of Or Day After Procedure"
        intersect "No Mechanical VTE Prophylaxis Due To Medical Reason On Day Of Or Day After Procedure"
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal":
  ( "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
      where NoVTEMedication.medicationStatusReason in "Patient Refusal"
  )
    union ( "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
        where NoVTEDevice.requestStatusReason in "Patient Refusal"
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No VTE Prophylaxis Due To Patient Refusal From Day Of Start Of Hospitalization To Day After First ICU Stay":
  "Encounter With ICU Location" QualifyingEncounterICU
    with "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal" PatientRefusal
      such that PatientRefusal.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "No VTE Prophylaxis Due To Patient Refusal On Day Of Or Day After Procedure":
  from
    "Encounter With ICU Location" QualifyingEncounterICU,
    ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
    "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal" PatientRefusal
    where AnesthesiaProcedure.status = 'completed'
      and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
      and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
    return QualifyingEncounterICU
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With No VTE Prophylaxis Due To Patient Refusal":
  "No VTE Prophylaxis Due To Patient Refusal From Day Of Start Of Hospitalization To Day After First ICU Stay"
    union "No VTE Prophylaxis Due To Patient Refusal On Day Of Or Day After Procedure"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Numerator":
  "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure"
    union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure"
        intersect ( "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE"
            union "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery"
        )
    )
    union "Encounter With Low Risk For VTE Or Anticoagulant Administered"
    union "Encounter With No VTE Prophylaxis Due To Medical Reason"
    union "Encounter With No VTE Prophylaxis Due To Patient Refusal"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Denominator":
  "Encounter With ICU Location"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "SDE Payer":
  SDE."SDE Payer"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Initial Population":
  VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "SDE Ethnicity":
  SDE."SDE Ethnicity"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With ICU Location And Encounter Less Than 2 Days":
  "Encounter With ICU Location" QualifyingEncounterICU
    where QualifyingEncounterICU.period.lengthInDays ( ) < 2
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery":
  "Encounter With ICU Location" QualifyingEncounterICU
    where QualifyingEncounterICU.hasPrincipalProcedureOf ( "General Surgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Gynecological Surgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Hip Fracture Surgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Hip Replacement Surgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Intracranial Neurosurgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Knee Replacement Surgery" )
      or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Urological Surgery" )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Intervention Comfort Measures":
  ( ["ServiceRequest": "Comfort Measures"] InterventionRequest
      where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and InterventionRequest.status in { 'active', 'completed' }
  )
    union ( ["Procedure": "Comfort Measures"] InterventionPerformed
        where InterventionPerformed.status in { 'completed', 'in-progress' }
    )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay":
  "Encounter With ICU Location" QualifyingEncounterICU
    with "Intervention Comfort Measures" ComfortMeasure
      such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure":
  from
    "Encounter With ICU Location" QualifyingEncounterICU,
    ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
    "Intervention Comfort Measures" ComfortMeasure
    where AnesthesiaProcedure.status = 'completed'
      and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
      and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
    return QualifyingEncounterICU
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Denominator Exclusions":
  "Encounter With ICU Location And Encounter Less Than 2 Days"
    union "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery"
    union "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay"
    union "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "SDE Race":
  SDE."SDE Race"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Encounter With First ICU Location Stay Less Than 1 Day":
  "Encounter With ICU Location" QualifyingEncounterICU
    where QualifyingEncounterICU.firstInpatientIntensiveCareUnit ( ).period.lengthInDays ( ) < 1
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define "Denominator Exceptions":
  "Encounter With First ICU Location Stay Less Than 1 Day"
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define fluent function "startOfFirstICU"(Encounter Encounter):
  start of Encounter.firstInpatientIntensiveCareUnit ( ).period
Logic Definition Library Name: CMS190FHIRVTEProphylaxisICU 
define fluent function "fromDayOfStartOfHospitalizationToDayAfterFirstICU"(Encounter Encounter):
  Interval[date from ( start of Encounter.hospitalizationWithObservation ( ) ), date from ( Encounter.startOfFirstICU ( ) ) + 1 day]
Logic Definition Library Name: USQualityCoreCommon 
/*
@description: Returns the value of the recorded extension for a Medication Administration Not Done
*/
define fluent function reasonRefused(serviceNotRequested ServiceNotRequested):
  serviceNotRequested.ext('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason').value as FHIR.CodeableConcept
Logic Definition Library Name: VTE 
define "Admission Without VTE Or Obstetrical Conditions":
  CQMCommon."Inpatient Encounter" InpatientEncounter
  where not (InpatientEncounter.hasEncDiagnosisOf("Obstetrical or Pregnancy Related Conditions")
             or InpatientEncounter.hasEncDiagnosisOf("Venous Thromboembolism")
             or InpatientEncounter.hasEncDiagnosisOf("Obstetrics VTE")
            )
Logic Definition Library Name: VTE 
define "Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions":
 "Admission Without VTE Or Obstetrical Conditions" EncounterWithoutConditions
     where AgeInYearsAt(date from start of EncounterWithoutConditions.period) >= 18
Logic Definition Library Name: VTE 
define fluent function hasEncDiagnosisOf(TheEncounter Encounter, DiagnosisValueSet System.ValueSet):
   TheEncounter E
     return (E.encounterDiagnosis()).code in DiagnosisValueSet
       or E.reasonCode in DiagnosisValueSet
Logic Definition Library Name: VTE 
define fluent function hasPrincipalProcedureOf(TheEncounter Encounter, DiagnosisValueSet System.ValueSet):
   TheEncounter E
   let
        PPx: E.principalProcedure(),
        CPx: singleton from ([Procedure] P where PPx.procedure.references(P.id))
     return PPx.procedure in DiagnosisValueSet
       or CPx.code in DiagnosisValueSet
Logic Definition Library Name: CQMCommon 
define "Inpatient Encounter":
  [Encounter: "Encounter Inpatient"] EncounterInpatient
    where EncounterInpatient.status = 'finished'
      and EncounterInpatient.period ends during day of "Measurement Period"
Logic Definition Library Name: CQMCommon 
/*  
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
  Encounter.reasonReference D
    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))
Logic Definition Library Name: CQMCommon 
/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference):
  singleton from (
    [Location] L where reference.references(L)
  )
Logic Definition Library Name: CQMCommon 
/*
@description: First Inpatient Intensive Care Unit returns the first intensive care unit for the given encounter, without considering any immediately prior emergency department visit.
*/
define fluent function firstInpatientIntensiveCareUnit(Encounter Encounter ):
  First((Encounter.location)HospitalLocation
  			where GetLocation(HospitalLocation.location).type in "Intensive Care Unit"
  				and HospitalLocation.period during Encounter.period
  			sort by start of period
  	)
Logic Definition Library Name: CQMCommon 
/*
@description: Returns the Location resource specified by the given reference
@deprecated: This function is deprecated. Use the fluent function `getLocation()` instead.
*/
define function "GetLocation"(reference Reference):
  singleton from (
    [Location] L where reference.references(L)
  )
Logic Definition Library Name: CQMCommon 
/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
  TheEncounter Visit
  		let ObsVisit: Last([Encounter: "Observation Services"] LastObs
  				where LastObs.status = 'finished'
            and LastObs.period ends 1 hour or less on or before start of Visit.period
  				sort by end of period
  			),
  			VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
  			EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
  				where LastED.status = 'finished'
            and LastED.period ends 1 hour or less on or before VisitStart
  				sort by end of period
  			)
  		return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]
Logic Definition Library Name: CQMCommon 
/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
  difference in days between start of Value and end of Value
Logic Definition Library Name: CQMCommon 
/*
@description: Returns the claim procedure elements for the given encounter
*/
define fluent function principalProcedure(encounter Encounter):  	  
  	 encounter E
  	 let 
        claim: [Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E)),
        claimItem: claim.item I where I.encounter.references(E),
        princProcedure: singleton from (claim.procedure P where P.sequence in claimItem.procedureSequence and P.type.includesCode("Primary procedure"))
    return princProcedure
Logic Definition Library Name: FHIRHelpers 
define function ToString(value string): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value EncounterStatus): value.value
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }
Logic Definition Library Name: FHIRHelpers 
define function ToDate(value date): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value MedicationAdministrationStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value ProcedureStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToDateTime(value dateTime): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToDateTime(value instant): value.value
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) 
value to a CQL Quantity
@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity
has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)
an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.
@seealso: ToCalendarUnit
*/
define function ToQuantity(quantity FHIR.Quantity):
    case
        when quantity is null then null
        when quantity.value is null then null
        when quantity.comparator is not null then
            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
        else
            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')
    end
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts a UCUM definite duration unit to a CQL calendar duration
unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) 
topic of the CQL specification.
@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate
*/
define function ToCalendarUnit(unit System.String):
    case unit
        when 'ms' then 'millisecond'
        when 's' then 'second'
        when 'min' then 'minute'
        when 'h' then 'hour'
        when 'd' then 'day'
        when 'wk' then 'week'
        when 'mo' then 'month'
        when 'a' then 'year'
        else unit
    end
Logic Definition Library Name: FHIRHelpers 
define function ToString(value ObservationStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value MedicationRequestIntent): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value MedicationRequestStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value ServiceRequestIntent): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value ServiceRequestStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value ClaimStatus): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value Use): value.value
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns the single extension (if present) on the given resource with the specified url.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given resource with the specified url.
*/
define fluent function ext(domainResource DomainResource, url String):
  singleton from domainResource.exts(url)
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns any extensions defined on the given resource with the specified url
*/
define fluent function exts(domainResource DomainResource, url String):
  domainResource.extension E
    where E.url = url
    return E
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resourceId String):
  resourceId = Last(Split(reference.reference, '/'))
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
  resource.id = Last(Split(reference.reference, '/'))
Logic Definition Library Name: FHIRCommon 
/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in FHIR, allowing this function to be used across any resource.

The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.
If the input is a Period, the result is a DateTime Interval.
If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.
If the input is an instant, the result is a DateTime Interval beginning and ending on that instant.
If the input is a string, an error is raised indicating a single interval cannot be computed from a string.
If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,
and ending immediately prior to when the patient was the given Age plus one year.
If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given
by the low end of the Range, and ending immediately prior to when the patient was the Age given by the
high end of the Range plus one year.

NOTE: Due to the
complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used
with a Timing or String.
*/
define fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):
  case
    when choice is FHIR.dateTime then
      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]
    when choice is FHIR.Period then
      FHIRHelpers.ToInterval(choice as FHIR.Period)
    when choice is FHIR.instant then
      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]
    when choice is FHIR.Age then
      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),
        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)
    when choice is FHIR.Range then
      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),
        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)
    when choice is FHIR.Timing then
      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')
    when choice is FHIR.string then
      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
    else
      null as Interval<DateTime>
  end
Logic Definition Library Name: FHIRCommon 
/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Age, FHIR.Range>):
  (choice.toInterval()) period
    return
      if (period.hasStart()) then start of period
      else end of period
Logic Definition Library Name: FHIRCommon 
/*
@description: Given an interval, return true if the interval has a starting boundary specified
(i.e. the start of the interval is not null and not the minimum DateTime value)
*/
define fluent function hasStart(period Interval<DateTime>):
  not ( start of period is null
      or start of period = minimum DateTime
  )
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns the single extension (if present) on the given element with the specified url.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given element with the specified url.
*/
define fluent function ext(element Element, url String):
  singleton from element.exts(url)
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns any extensions defined on the given element with the specified url.
*/
define fluent function exts(element Element, url String):
  element.extension E
    where E.url = url
    return E
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<FHIR.Reference>, resource FHIR.Resource):
  exists (references R where R.references(resource))
Logic Definition Library Name: FHIRCommon 
/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List<CodeableConcept>, code Concept):
  exists (codeList C where C ~ code)
Logic Definition Library Name: USCoreCommon 
/*
@description: Returns the sex element as defined for the USCore patient profile
*/
define fluent function sex(patient Patient):
  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code
Logic Definition Library Name: USCoreCommon 
define fluent function ethnicity(patient Patient):
  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E
    return {
      ombCategory: E.ext('ombCategory').value as FHIR.Coding,
      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
      text: E.ext('text').value as FHIR.string
    }
Logic Definition Library Name: USCoreCommon 
define fluent function race(patient Patient):
  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E
    return {
      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,
      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
      text: E.ext('text').value as FHIR.string
    }
Terminology
Code System Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Code System Description: Code system ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status
Code System Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Code System Description: Code system TaskCodeSystem
Resource: Task Codes
Canonical URL: http://hl7.org/fhir/CodeSystem/task-code
Code System Description: Code system Procedure Type
Resource: Example Procedure Type Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/ex-procedure-type
Value Set 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
Value Set Description: Value set Obstetrical or Pregnancy Related Conditions
Resource: Obstetrical or Pregnancy Related Conditions
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263
Value Set Description: Value set Venous Thromboembolism
Resource: Venous Thromboembolism
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279
Value Set Description: Value set Obstetrics VTE
Resource: Obstetrics VTE
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264
Value Set Description: Value set Intensive Care Unit
Resource: Intensive Care Unit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.206
Value Set Description: Value set Low Dose Unfractionated Heparin for VTE Prophylaxis
Resource: Low Dose Unfractionated Heparin for VTE Prophylaxis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
Value Set Description: Value set Subcutaneous route
Resource: Subcutaneous route
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223
Value Set Description: Value set Low Molecular Weight Heparin for VTE Prophylaxis
Resource: Low Molecular Weight Heparin for VTE Prophylaxis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
Value Set Description: Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis
Resource: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
Value Set Description: Value set Warfarin
Resource: Warfarin
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
Value Set Description: Value set Rivaroxaban for VTE Prophylaxis
Resource: Rivaroxaban for VTE Prophylaxis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50
Value Set Description: Value set Application of Intermittent Pneumatic Compression Devices
Resource: Application of Intermittent Pneumatic Compression Devices
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65
Value Set Description: Value set Application of Venous Foot Pumps
Resource: Application of Venous Foot Pumps
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64
Value Set Description: Value set Application of Graduated Compression Stockings
Resource: Application of Graduated Compression Stockings
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66
Value Set Description: Value set General or Neuraxial Anesthesia
Resource: General or Neuraxial Anesthesia
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743
Value Set Description: Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
Resource: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134
Value Set Description: Value set Atrial Fibrillation or Flutter
Resource: Atrial Fibrillation or Flutter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202
Value Set Description: Value set Hip Replacement Surgery
Resource: Hip Replacement Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259
Value Set Description: Value set Knee Replacement Surgery
Resource: Knee Replacement Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261
Value Set Description: Value set Low Risk
Resource: Low Risk
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400
Value Set Description: Value set INR
Resource: INR
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
Value Set Description: Value set Unfractionated Heparin
Resource: Unfractionated Heparin
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218
Value Set Description: Value set Intravenous route
Resource: Intravenous route
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222
Value Set Description: Value set Direct Thrombin Inhibitor
Resource: Direct Thrombin Inhibitor
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205
Value Set Description: Value set Glycoprotein IIb IIIa Inhibitors
Resource: Glycoprotein IIb IIIa Inhibitors
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41
Value Set Description: Value set Observation Services
Resource: Observation Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Value Set Description: Value set Emergency Department Visit
Resource: Emergency Department Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Value Set Description: Value set Medical Reason For Not Providing Treatment
Resource: Medical Reason For Not Providing Treatment
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473
Value Set Description: Value set Venous foot pumps
Resource: Venous foot pumps
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
Value Set Description: Value set Intermittent pneumatic compression devices
Resource: Intermittent pneumatic compression devices
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
Value Set Description: Value set Graduated compression stockings
Resource: Graduated compression stockings
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
Value Set Description: Value set Patient Refusal
Resource: Patient Refusal
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93
Value Set 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
Value Set Description: Value set General Surgery
Resource: General Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255
Value Set Description: Value set Gynecological Surgery
Resource: Gynecological Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257
Value Set Description: Value set Hip Fracture Surgery
Resource: Hip Fracture Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258
Value Set Description: Value set Intracranial Neurosurgery
Resource: Intracranial Neurosurgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260
Value Set Description: Value set Urological Surgery
Resource: Urological Surgery
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272
Value Set Description: Value set Comfort Measures
Resource: Comfort Measures
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Direct Reference Code Display: Male (finding)
Code: 248153007
System: http://snomed.info/sct
Direct Reference Code Display: Female (finding)
Code: 248152002
System: http://snomed.info/sct
Direct Reference Code Display: refuted
Code: refuted
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: entered-in-error
Code: entered-in-error
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: inactive
Code: inactive
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: remission
Code: remission
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: resolved
Code: resolved
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: Risk for venous thromboembolism
Code: 72136-5
System: http://loinc.org
Direct Reference Code Display: Fulfill
Code: fulfill
System: http://hl7.org/fhir/CodeSystem/task-code
Direct Reference Code Display: Primary procedure
Code: primary
System: http://terminology.hl7.org/CodeSystem/ex-procedure-type
Dependencies
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 VTE
Resource: VTE version: 9.1.000
Canonical URL: https://madie.cms.gov/Library/VTE|9.1.000
Dependency Description: Library CQMCommon
Resource: CQMCommon version: 5.1.000
Canonical URL: https://madie.cms.gov/Library/CQMCommon|5.1.000
Dependency Description: Library TJC
Resource: TJCOverall version: 9.1.000
Canonical URL: https://madie.cms.gov/Library/TJCOverall|9.1.000
Dependency Description: Library Status
Resource: Status version: 2.1.000
Canonical URL: https://madie.cms.gov/Library/Status|2.1.000
Dependency Description: Library USQualityCoreCommon
Resource: US Quality Core Common version: 0.1.0-cibuild
Canonical URL: https://madie.cms.gov/Library/USQualityCoreCommon|0.1.0-cibuild
Data Requirements
Data Requirement Type: Patient
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient
Must Support Elements: ombCategory, detailed, text
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: location, reasonCode, period
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period, reasonCode
Code Filter(s):
Path: type
ValueSet: Observation Services
Path: status
Code(s): [not stated]: finished (finished)
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period, reasonCode
Code Filter(s):
Path: type
ValueSet: Emergency Department Visit
Path: status
Code(s): [not stated]: finished (finished)
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period, reasonCode, location
Code Filter(s):
Path: type
ValueSet: Encounter Inpatient
Path: status
Code(s): [not stated]: finished (finished)
Data Requirement Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis
Data Requirement Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns
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, verificationStatus, onset
Code Filter(s):
Path: code
ValueSet: Atrial Fibrillation or Flutter
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, clinicalStatus, verificationStatus, onset
Code Filter(s):
Path: code
ValueSet: Venous Thromboembolism
Data Requirement Type: Resource
Profile(s): Resource
Must Support Elements: id
Data Requirement Type: Location
Profile(s): Location
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Unfractionated Heparin
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Direct Thrombin Inhibitor
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Glycoprotein IIb IIIa Inhibitors
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Low Dose Unfractionated Heparin for VTE Prophylaxis
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Low Molecular Weight Heparin for VTE Prophylaxis
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Warfarin
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Rivaroxaban for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Low Dose Unfractionated Heparin for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Low Molecular Weight Heparin for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Warfarin
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Rivaroxaban for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Unfractionated Heparin
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication.reference, status, dosage, dosage.route, effective, id
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Direct Thrombin Inhibitor
Data Requirement Type: MedicationAdministration
Profile(s): MedicationAdministration
Must Support Elements: medication, status, dosage, dosage.route, effective, id
Code Filter(s):
Path: medication
ValueSet: Glycoprotein IIb IIIa Inhibitors
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Application of Intermittent Pneumatic Compression Devices
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Application of Venous Foot Pumps
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Application of Graduated Compression Stockings
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Hip Replacement Surgery
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Knee Replacement Surgery
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: id, status, performed, code
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed
Code Filter(s):
Path: code
ValueSet: Comfort Measures
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, status, performed, performed.low, performed.lowClosed, performed.high, performed.highClosed
Code Filter(s):
Path: code
ValueSet: General or Neuraxial Anesthesia
Path: status
Code(s): [not stated]: completed (completed)
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: birthDate
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation
Must Support Elements: code, value, status, id, effective
Code Filter(s):
Path: code
Code(s): LOINC: 72136-5 (Risk for venous thromboembolism)
Path: value
ValueSet: Low Risk
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: code, value, status, id, issued
Code Filter(s):
Path: code
ValueSet: INR
Data Requirement Type: MedicationAdministration
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone
Must Support Elements: medication, id, statusReason, effective
Code Filter(s):
Path: medication
ValueSet: Low Dose Unfractionated Heparin for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone
Must Support Elements: medication, id, statusReason, effective
Code Filter(s):
Path: medication
ValueSet: Low Molecular Weight Heparin for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone
Must Support Elements: medication, id, statusReason, effective
Code Filter(s):
Path: medication
ValueSet: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Data Requirement Type: MedicationAdministration
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone
Must Support Elements: medication, id, statusReason, effective
Code Filter(s):
Path: medication
ValueSet: Warfarin
Data Requirement Type: MedicationAdministration
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone
Must Support Elements: medication, id, statusReason, effective
Code Filter(s):
Path: medication
ValueSet: Rivaroxaban for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested
Must Support Elements: medication, intent, status, id, reasonCode, authoredOn
Code Filter(s):
Path: medication
ValueSet: Low Dose Unfractionated Heparin for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested
Must Support Elements: medication, intent, status, id, reasonCode, authoredOn
Code Filter(s):
Path: medication
ValueSet: Low Molecular Weight Heparin for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested
Must Support Elements: medication, intent, status, id, reasonCode, authoredOn
Code Filter(s):
Path: medication
ValueSet: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested
Must Support Elements: medication, intent, status, id, reasonCode, authoredOn
Code Filter(s):
Path: medication
ValueSet: Warfarin
Data Requirement Type: MedicationRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested
Must Support Elements: medication, intent, status, id, reasonCode, authoredOn
Code Filter(s):
Path: medication
ValueSet: Rivaroxaban for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication.reference, status, id, authoredOn
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, id, authoredOn
Code Filter(s):
Path: medication
ValueSet: Low Dose Unfractionated Heparin for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, id, authoredOn
Code Filter(s):
Path: medication
ValueSet: Low Molecular Weight Heparin for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, id, authoredOn
Code Filter(s):
Path: medication
ValueSet: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, id, authoredOn
Code Filter(s):
Path: medication
ValueSet: Warfarin
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, id, authoredOn
Code Filter(s):
Path: medication
ValueSet: Rivaroxaban for VTE Prophylaxis
Data Requirement Type: Task
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-taskrejected
Must Support Elements: focus, code, statusReason
Code Filter(s):
Path: code
Data Requirement Type: ServiceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicenotrequested
Must Support Elements: code, intent, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Venous foot pumps
Data Requirement Type: ServiceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicenotrequested
Must Support Elements: code, intent, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Intermittent pneumatic compression devices
Data Requirement Type: ServiceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicenotrequested
Must Support Elements: code, intent, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Graduated compression stockings
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: code, intent, status, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Venous foot pumps
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: code, intent, status, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Intermittent pneumatic compression devices
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: code, intent, status, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Graduated compression stockings
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: code, intent, status, id, authoredOn
Code Filter(s):
Path: code
ValueSet: Comfort Measures
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedurenotdone
Must Support Elements: code, performed, id, statusReason
Code Filter(s):
Path: code
ValueSet: Application of Intermittent Pneumatic Compression Devices
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedurenotdone
Must Support Elements: code, performed, id, statusReason
Code Filter(s):
Path: code
ValueSet: Application of Venous Foot Pumps
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedurenotdone
Must Support Elements: code, performed, id, statusReason
Code Filter(s):
Path: code
ValueSet: Application of Graduated Compression Stockings
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: Claim
Profile(s): Claim
Must Support Elements: status, use, item
Code Filter(s):
Path: status
Code(s): [not stated]: active (active)
Path: use
Code(s): [not stated]: claim (claim)
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
SDE Sex Out 0..1 Coding
Numerator Out 0..* Encounter
Denominator Out 0..* Encounter
SDE Payer Out 0..* Resource
Initial Population Out 0..* Encounter
SDE Ethnicity Out 0..1 Resource
Denominator Exclusions Out 0..* Encounter
SDE Race Out 0..1 Resource
Denominator Exceptions Out 0..* Encounter
Generated using version 0.5.4 of the sample-content-ig Liquid templates