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 |
{
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"narrative-table\">\n <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">Intravesical Bacillus-Calmette-Guerin for Non-Muscle Invasive Bladder CancerFHIR\n</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">1.0.000</td>\n\n\n</tr>\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n\n<td class=\"content-container\">CMS646FHIR</td>\n\n\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:907ead5a-2f8f-468e-b774-309ea8aa6182</td>\n\n\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:67c8554c-9288-4de2-b8dc-45ae4673e032</td>\n\n\n</tr>\n\n\n\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n\n<td class=\"content-container\">646FHIR</td>\n\n\n</tr>\n\n \n\n\n\n\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n\n\n</tr>\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n\n<td class=\"content-container\">Oregon Urology</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n\n<td class=\"content-container\">Oregon Urology</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n\n<td class=\"content-container\"><div><p>Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Oregon Urology Institute (OUI) and Large Urology Group Practice Association (LUGPA) disclaim all liability for the use or accuracy of third-party codes contained in the specifications.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-2024. American Medical Association. 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.</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n\n<td class=\"content-container\"><div><p>The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications.</p>\n<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by TM or [TM].</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n\n<td class=\"content-container\"><div><p>Bladder cancer is ranked 10th for new cancer cases in 2020 and is the ninth leading cause of cancer death in the United States. There are 81,400 estimated new cases in 2020 and 17,980 estimated deaths in 2020. In 2016, an estimated 699,450 people were living with bladder cancer in the United States. Early detection (discovery of cancer in situ or localized to the primary site) is found in 85% of the patients, and with these there is a five-year survival rate of 95.8% for In Situ and 69.2% for Localized. Bladder cancer is rarely found in patients under age 20, with the median age of diagnosis being 73 (NIH, 2020).</p>\n<p>National Comprehensive Cancer Network (NCCN) Guidelines for Bladder Cancer (version 6.2021) defines intravesical BCG as Category 1 Treatment for T1, Tis and Ta - high grade, non-muscle invasive bladder cancer. Most public data reflects prophylactic or adjuvant use of intravesical therapy to prevent recurrence or delay progression to a higher grade or stage. BCG has been shown to be effective as prophylaxis to prevent bladder cancer recurrences following TURBT. The NCCN Bladder Cancer Panel Members recommend BCG as the preferred option over Mitomycin C for adjuvant treatment of high-grade lesions (Ta). BCG is also standard therapy for Primary Tis. Most T1 lesions are high-risk and are similarly treated with adjuvant intravesical therapy, with BCG being a Category 1 recommendation (NCCN, 2021).</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n\n<td class=\"content-container\"><div><p>Intravesical BCG should be administered within 6 months of the initial diagnosis of non-muscle invasive bladder cancer. It may be administered 3-4 weeks after resection, but there needs to be pathological tumor confirmation and must be withheld if there is traumatic catheterization, bacteriuria, persistent gross hematuria, persistent severe local symptoms or systemic symptoms. The normal induction course is 6 weekly instillations of intravesical BCG (AUA Non-Muscle Invasive Bladder Cancer and American Urological Association (AUA) Guideline for the Management of Non-muscle Invasive Bladder Cancer: Stages T1, TIS, and Ta High Risk).</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>Chamie, K., Saigal, C.S., Lai, J., Hanley, J.M., Setodji, C.M., Konety, B.R., ... Urologic Diseases in America Project (2011). Compliance with Guidelines for Patients with Bladder Cancer: Variation in the Delivery of Care. Cancer.2011 Dec 1: 117(23): 5392-5401. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206145/</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>Chang, S.S., Boorjian, S.A., Chou, R., Clark, P.E., Daneshmand, S., Konety, B.R., ... Mckiernan, J. M., (2016) American Urological Association. Non-Muscle Invasive Bladder Cancer. https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-muscle-invasive-guideline</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>Hall, M.C., Chang, S.S., Dalbagni, G., Pruthi, R.S., Schellhammer, P.F., Seigne, J.D., ... Wolf, S., (2016). American Urological Association. Guideline for the Management of Non-muscle Invasive Bladder Cancer (Stages Ta, T1, and Tis): Update 2016. https://www.auajournals.org/doi/10.1016/j.juro.2007.09.003</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>Kassouf, W., Black, P., (2016) Treatment of primary non-muscle invasive urothelial bladder cancer. Literature review current through Dec. 2016. https://www.uptodate.com/contents/treatment-of-primary-non-muscle-invasive-urothelial-bladder-cancer?source=search_result&search=Treatment%20of%20primary%20non-muscle%20invasive%20urothelial%20bladder%20cancer&selectedTitle=1~150 T of primary</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>National Cancer Institute. (2020). SEER Cancer Stat Facts: Bladder Cancer. Surveillance, Epidemiology, and End Results Program. U.S. Department of Health and Human Services, National Institutes of Health. https://seer.cancer.gov/statfacts/html/urinb.html</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). (2021). Bladder Cancer. Version 6.2021. https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n \n <td class=\"content-container\">\n \n \n \n <div><p>Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University. (2016). PCORI Topic Brief. Comparative Effectiveness of Treatments for Non-Muscle-Invasive Bladder Cancer http://www.pcori.org/sites/default/files/PCORI-Assessment-Options-Advisory-Panel-Fall-2016-Topic-Brief-Non-Muscle-Invasive-Bladder-Cancer.pdf</p>\n</div>\n \n \n \n \n \n \n \n </td>\n</tr>\n\n\n\n\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Bacillus Calmette-Guerin (BCG) : A live attenuated strain of *Mycobacterium bovis*, first indicated as a tuberculosis vaccine, has had widespread use in intravesical immunotherapy since the 1970s\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Histology: Urothelial carcinoma\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Intravesical: Within the urinary bladder\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Primary Tumor (T) Stage - T1: The tumor invades subepithelial connective tissue (high grade or low grade)\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Primary Tumor (T) Stage - Ta: Noninvasive and high grade\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Primary Tumor (T) Stage - Tis: Carcinoma in situ: "flat tumor"\n</td>\n\n\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Tumor Location: Urinary bladder\n</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n\n<td class=\"content-container\">Ta bladder cancer must be high grade Ta only and is supported by the 2016 AUA guidelines and 2018 NCCN guidelines.\n\nThe BCG dose can be full or partial and can be from any lot or manufacturer.\n\nThis eCQM is a patient-based measure.\n\nTelehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS646v6. 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</td>\n\n\n</tr>\n\n\n\n \n \n \n \n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n \n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n\n<td class=\"content-container\">boolean</td>\n\n\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n\n<td class=\"content-container\">\n Proportion\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n\n<td class=\"content-container\">\n Increased score indicates improvement\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n Process\n\n\n</td>\n\n\n</tr>\n\n\n\n\n \n \n\n \n \n \n \n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: InitialPopulation_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\">All patients initially diagnosed with T1, Tis or high grade Ta non-muscle invasive bladder cancer with bladder cancer staging within 6 months before to 6 months after the start of the measurement period and a qualified encounter in the measurement period\n</p>\n \n \n \n \n \n <em>Criteria</em>: <a href=\"#Group_1-InitialPopulation_1\">Initial Population</a> \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n \n\n \n \n \n \n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: Denominator_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\">Equals Initial Population\n</p>\n \n \n \n \n \n <em>Criteria</em>: <a href=\"#Group_1-Denominator_1\">Denominator</a> \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n \n\n \n \n \n \n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Denominator Exclusion</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: DenominatorExclusion_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\">Immunosuppressed patients, includes HIV and immunocompromised state, with a diagnosis prior to Bladder Cancer Staging.\n\nImmunosuppressive drug therapy starting on or before Bladder Cancer Staging.\n\nActive Tuberculosis diagnosis during the Bladder Cancer Staging.\n\nMixed histology urothelial cell carcinoma including micropapillary, plasmacytoid, sarcomatoid, adenocarcinoma and squamous disease prior to Bladder Cancer Staging.\n\nPatients who undergo cystectomy, chemotherapy or radiation within 6 months prior to Bladder Cancer Staging.\n</p>\n \n \n \n \n \n <em>Criteria</em>: <a href=\"#Group_1-DenominatorExclusion_1\">Denominator Exclusion</a> \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n \n\n \n \n \n \n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Denominator Exception</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: DenominatorException_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\">Unavailability of BCG within 6 months after Bladder Cancer Staging\n</p>\n \n \n \n \n \n <em>Criteria</em>: <a href=\"#Group_1-DenominatorException_1\">Denominator Exception</a> \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n \n\n \n \n \n \n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: Numerator_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\">Intravesical Bacillus-Calmette Guerin (BCG) instillation for initial dose or series: BCG is initiated within 6 months of the bladder cancer staging\n</p>\n \n \n \n \n \n <em>Criteria</em>: <a href=\"#Group_1-Numerator_1\">Numerator</a> \n \n \n \n \n \n \n </td>\n </tr>\n \n\n \n \n\n \n \n \n\n \n\n\n \n\n\n\n\n\n\n\n \n \n \n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\"/>\n\n\n\n<td class=\"content-container\"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></td>\n\n\n</tr>\n\n \n\n\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-ethnicity\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n \n <br/>\n \n \n \n <em>Description</em>: SDE Ethnicity\n\n \n \n \n <br/>\n \n \n <em>Logic Definition</em>: <a href=\"#cms646fhirintravesicalbcgtherapy-sde-ethnicity\">SDE Ethnicity</a> \n \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-payer\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n \n <br/>\n \n \n \n <em>Description</em>: SDE Payer\n\n \n \n \n <br/>\n \n \n <em>Logic Definition</em>: <a href=\"#cms646fhirintravesicalbcgtherapy-sde-payer\">SDE Payer</a> \n \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-race\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n \n <br/>\n \n \n \n <em>Description</em>: SDE Race\n\n \n \n \n <br/>\n \n \n <em>Logic Definition</em>: <a href=\"#cms646fhirintravesicalbcgtherapy-sde-race\">SDE Race</a> \n \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-sex\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n \n <br/>\n \n \n \n <em>Description</em>: SDE Sex\n\n \n \n \n <br/>\n \n \n <em>Logic Definition</em>: <a href=\"#cms646fhirintravesicalbcgtherapy-sde-sex\">SDE Sex</a> \n \n \n \n </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n\n<td class=\"content-container\"><code>https://madie.cms.gov/Library/CMS646FHIRIntravesicalBCGTherapy</code></td>\n\n\n</tr>\n\n\n\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Contents</th>\n <td class=\"content-container\">\n <em><a href=\"#population-criteria\">Population Criteria</a></em>\n <br/>\n <em><a href=\"#definitions\">Logic Definitions</a></em>\n <br/>\n <em><a href=\"#terminology\">Terminology</a></em>\n <br/>\n <em><a href=\"#dependencies\">Dependencies</a></em>\n <br/>\n <em><a href=\"#data-requirements\">Data Requirements</a></em>\n <br/>\n <em><a href=\"#parameters\">Parameters</a></em>\n <br/>\n </td>\n</tr>\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n \n \n \n\n \n \n \n \n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n Initial Population\n \n </th>\n</tr>\n<tr>\n\n <td>\n \n \n \n \n \n <a name=\"Group_1-InitialPopulation_1\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n "Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG"\n and "Has Qualifying Encounter"</code></pre>\n \n \n <a href=\"#cms646fhirintravesicalbcgtherapy-initial-population\"><em>Definition</em></a>\n \n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n Denominator\n \n </th>\n</tr>\n<tr>\n\n <td>\n \n \n \n \n \n <a name=\"Group_1-Denominator_1\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n \n \n <a href=\"#cms646fhirintravesicalbcgtherapy-denominator\"><em>Definition</em></a>\n \n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n Denominator Exclusion\n \n </th>\n</tr>\n<tr>\n\n <td>\n \n \n \n \n \n <a name=\"Group_1-DenominatorExclusion_1\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusion":\n exists "Acute Tuberculosis Diagnosis"\n or exists "Immunosuppressive Drugs"\n or exists "Cystectomy Done"\n or "Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging"\n or "Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging"</code></pre>\n \n \n <a href=\"#cms646fhirintravesicalbcgtherapy-denominator-exclusion\"><em>Definition</em></a>\n \n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n Denominator Exception\n \n </th>\n</tr>\n<tr>\n\n <td>\n \n \n \n \n \n <a name=\"Group_1-DenominatorException_1\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator Exception":\n exists "BCG Not Available Within 6 Months After Bladder Cancer Staging"</code></pre>\n \n \n <a href=\"#cms646fhirintravesicalbcgtherapy-denominator-exception\"><em>Definition</em></a>\n \n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n Numerator\n \n </th>\n</tr>\n<tr>\n\n <td>\n \n \n \n \n \n <a name=\"Group_1-Numerator_1\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "First BCG Administered" is not null</code></pre>\n \n \n <a href=\"#cms646fhirintravesicalbcgtherapy-numerator\"><em>Definition</em></a>\n \n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n\n \n\n\n \n\n\n \n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n \n \n \n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"supplementaldataelements-sde-sex\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"supplementaldataelements-sde-payer\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [USQualityCore.Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n (Patient.ethnicity()) E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"supplementaldataelements-sde-race\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n (Patient.race()) R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-sde-sex\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-bladder-cancer-diagnosis\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Bladder Cancer Diagnosis":\n ( [ConditionProblemsHealthConcerns: "Bladder Cancer for Urology Care"]\n union [ConditionEncounterDiagnosis: "Bladder Cancer for Urology Care"] ) BladderCancer\n where ( BladderCancer.onset.toInterval ( ) starts before day of end of "Measurement Period"\n or BladderCancer.onset.toInterval ( ) before day of end of "Measurement Period"\n )\n and BladderCancer.isVerified ( )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-first-bladder-cancer-staging-procedure\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "First Bladder Cancer Staging Procedure":\n First([Procedure: "Tumor staging (tumor staging)"] BladderCancerStaging\n with "Bladder Cancer Diagnosis" BladderCancer\n such that BladderCancerStaging.performed.toInterval() starts on or before day of start of BladderCancer.onset.toInterval ( )\n where BladderCancerStaging.status = 'completed'\n sort by start of performed.toInterval()\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-first-bcg-administered\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "First BCG Administered":\n First([MedicationAdministration: "Bacillus Calmette Guerin for Urology Care"] BCG\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that BCG.effective.toInterval() starts 6 months or less after day of start of FirstBladderCancerStaging.performed.toInterval()\n and BCG.effective.toInterval() starts during day of "Measurement Period"\n where BCG.status in { 'in-progress', 'completed' }\n sort by start of effective.toInterval()\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-numerator\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "First BCG Administered" is not null</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-bcg-not-available-within-6-months-after-bladder-cancer-staging\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "BCG Not Available Within 6 Months After Bladder Cancer Staging":\n [MedicationAdministrationNotDone: "Bacillus Calmette Guerin for Urology Care"] BCGNotGiven\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that BCGNotGiven.effective 6 months or less after day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where BCGNotGiven.statusReason in "Unavailability of Bacillus Calmette Guerin for Urology Care"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-denominator-exception\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator Exception":\n exists "BCG Not Available Within 6 Months After Bladder Cancer Staging"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-july-1-of-year-prior-to-the-measurement-period\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "July 1 of Year Prior to the Measurement Period":\n Date((year from start of "Measurement Period" - 1), 7, 1)</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-june-30-of-the-measurement-period\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "June 30 of the Measurement Period":\n Date((year from start of "Measurement Period"), 6, 30)</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-first-bladder-cancer-staging-procedure-during-6-months-prior-to-measurement-period-through-the-first-6-months-of-measurement-period\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "First Bladder Cancer Staging Procedure during 6 Months Prior to Measurement Period through the First 6 Months of Measurement Period":\n "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n where FirstBladderCancerStaging.performed.toInterval ( ) during day of Interval["July 1 of Year Prior to the Measurement Period", "June 30 of the Measurement Period"]</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-has-most-recent-bladder-cancer-tumor-staging-is-t1,-tis,-ta-hg\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*Ta High Grade only to be included. Ta low grade is to be excluded from this measure.*/\n\n\ndefine "Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG":\n exists ( [LaboratoryResultObservation] StagingObservation\n where StagingObservation.getStagingProcedure ( ) is not null\n and ( StagingObservation.value as CodeableConcept ~ "American Joint Committee on Cancer cT1 (qualifier value)"\n or StagingObservation.value as CodeableConcept ~ "American Joint Committee on Cancer cTis (qualifier value)"\n or StagingObservation.value as CodeableConcept ~ "American Joint Committee on Cancer cTa (qualifier value)"\n or StagingObservation.value as CodeableConcept ~ "Carcinoma in situ of bladder"\n )\n and StagingObservation.status in { 'final', 'amended', 'corrected' }\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-has-qualifying-encounter\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Has Qualifying Encounter":\n exists ( [Encounter: "Office Visit"] ValidEncounter\n where ValidEncounter.period during day of "Measurement Period"\n and ValidEncounter.class !~ "virtual"\n and ValidEncounter.status = 'finished'\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-initial-population\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n "Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG"\n and "Has Qualifying Encounter"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-denominator\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-sde-payer\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-sde-ethnicity\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-acute-tuberculosis-diagnosis\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Acute Tuberculosis Diagnosis":\n ( [ConditionProblemsHealthConcerns: "Tuberculosis for Urology Care"]\n union [ConditionEncounterDiagnosis: "Tuberculosis for Urology Care"] ) ActiveTuberculosis\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that ( ( ActiveTuberculosis.onset.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ActiveTuberculosis.onset.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( )\n and ( ( ActiveTuberculosis.abatement.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ActiveTuberculosis.abatement is null )\n )\n )\n )\n where ActiveTuberculosis.isVerified ( )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-immunosuppressive-drugs\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Immunosuppressive Drugs":\n [MedicationRequest: "Immunosuppressive Drugs for Urology Care"] ImmunosuppressiveDrugs\n let firstMedicationPeriod: First((collapse(ImmunosuppressiveDrugs.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n //get the very first event\n \n firstMedicationEvent: First((ImmunosuppressiveDrugs.dosageInstruction.timing dosageTiming\n //return first event for the specific dosageTiming\n \n return First(dosageTiming.event dosageTimingEvents\n sort ascending\n )) firstEvents\n sort ascending\n ),\n medicationPeriod: Coalesce(firstMedicationEvent.toInterval(), firstMedicationPeriod)\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that medicationPeriod starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where ImmunosuppressiveDrugs.status in { 'active', 'completed' }\n and ImmunosuppressiveDrugs.intent = 'order'</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-cystectomy-done\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Cystectomy Done":\n [Procedure: "Cystectomy for Urology Care"] Cystectomy\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that Cystectomy.performed.toInterval ( ) 6 months or less before day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where Cystectomy.status = 'completed'</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-has-excluding-hiv,-immunocompromised-conditions-or-mixed-histology-before-staging\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging":\n exists ( ( ( [ConditionProblemsHealthConcerns: "HIV"]\n union [ConditionEncounterDiagnosis: "HIV"]\n )\n union ( [ConditionProblemsHealthConcerns: "Immunocompromised Conditions"]\n union [ConditionEncounterDiagnosis: "Immunocompromised Conditions"]\n )\n union ( [ConditionProblemsHealthConcerns: "Mixed Histology Urothelial Cell Carcinoma for Urology Care"]\n union [ConditionEncounterDiagnosis: "Mixed Histology Urothelial Cell Carcinoma for Urology Care"]\n ) ) ExclusionDiagnosis\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that ( ( ExclusionDiagnosis.onset.toInterval ( ) starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ExclusionDiagnosis.onset.toInterval ( ) starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( ) )\n )\n where ExclusionDiagnosis.isVerified ( )\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-has-excluding-chemotherapy-or-radiotherapy-procedure-before-staging\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging":\n exists ( ( [MedicationRequest: "Chemotherapy Agents for Advanced Cancer"] ExclusionMed\n let firstMedicationPeriod: First((collapse(ExclusionMed.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n )\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that firstMedicationPeriod starts 6 months or less before FirstBladderCancerStaging.performed.toInterval ( )\n where ExclusionMed.status in { 'active', 'completed' }\n and ExclusionMed.intent = 'order'\n )\n union ( [Procedure: "Combined radiotherapy (procedure)"] ExclusionProcedure\n with "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging\n such that ExclusionProcedure.performed.toInterval ( ) starts 6 months or less before FirstBladderCancerStaging.performed.toInterval ( )\n where ExclusionProcedure.status in { 'completed', 'in-progress' }\n )\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-denominator-exclusion\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusion":\n exists "Acute Tuberculosis Diagnosis"\n or exists "Immunosuppressive Drugs"\n or exists "Cystectomy Done"\n or "Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging"\n or "Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-sde-race\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-isverified\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define 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 )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS646FHIRIntravesicalBCGTherapy</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"cms646fhirintravesicalbcgtherapy-getstagingprocedure\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function getStagingProcedure(StagingObservation LaboratoryResultObservation):\n StagingObservation.partOf StagingReference\n return "First Bladder Cancer Staging Procedure during 6 Months Prior to Measurement Period through the First 6 Months of Measurement Period" FirstBladderCancerStagingMP\n where FirstBladderCancerStagingMP.id = StagingReference.reference.getId ( )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> USQualityCoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"usqualitycorecommon-getid\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the id of the given uri (i.e. everything after the last slash)\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhircommon-ext\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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)</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhircommon-exts\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhircommon-tointerval\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhircommon-ext\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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)</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhircommon-exts\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value string): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-toconcept\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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 }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tocode\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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 }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-todatetime\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value dateTime): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tointerval\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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]</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-todatetime\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value instant): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-todate\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDate(value date): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-toquantity\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tocalendarunit\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ProcedureStatus): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value MedicationAdministrationStatus): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ObservationStatus): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value EncounterStatus): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value MedicationRequestStatus): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value MedicationRequestIntent): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"uscorecommon-sex\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\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</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"uscorecommon-ethnicity\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">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 }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n \n \n \n \n <a name=\"uscorecommon-race\"> </a>\n \n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">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 }</code></pre>\n </td>\n\n</tr>\n\n\n\n\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n \n \n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system SNOMEDCT\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system ConditionVerificationStatusCodes\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system ICD10CM\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system ActCode\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-v3-ActCode.html\">ActCode</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Bacillus Calmette Guerin for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.353-20250312\">Bacillus Calmette Guerin for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.353</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Bladder Cancer for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.354-20250312\">Bladder Cancer for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.354</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Unavailability of Bacillus Calmette Guerin for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.369-20250312\">Unavailability of Bacillus Calmette Guerin for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.369</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Office Visit\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Payer Type\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Tuberculosis for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.351-20250312\">Tuberculosis for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.351</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Immunosuppressive Drugs for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.364-20260205\">Immunosuppressive Drugs for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.364</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Cystectomy for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.358-20250312\">Cystectomy for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.358</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set HIV\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.120.12.1003/expansion\">HIV</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Immunocompromised Conditions\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.363-20250312\">Immunocompromised Conditions</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.363</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Mixed Histology Urothelial Cell Carcinoma for Urology Care\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.365-20250312\">Mixed Histology Urothelial Cell Carcinoma for Urology Care</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.365</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Chemotherapy Agents for Advanced Cancer\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.355-20250312\">Chemotherapy Agents for Advanced Cancer</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.355</tt>\n \n </td>\n</tr>\n \n\n\n \n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Male (finding)\n <br/>\n \n <em>Code</em>: 248153007\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Female (finding)\n <br/>\n \n <em>Code</em>: 248152002\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Tumor staging (tumor staging)\n <br/>\n \n <em>Code</em>: 254292007\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: confirmed\n <br/>\n \n <em>Code</em>: confirmed\n <br/>\n <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: unconfirmed\n <br/>\n \n <em>Code</em>: unconfirmed\n <br/>\n <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: provisional\n <br/>\n \n <em>Code</em>: provisional\n <br/>\n <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: differential\n <br/>\n \n <em>Code</em>: differential\n <br/>\n <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: American Joint Committee on Cancer cT1 (qualifier value)\n <br/>\n \n <em>Code</em>: 1228889001\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: American Joint Committee on Cancer cTis (qualifier value)\n <br/>\n \n <em>Code</em>: 1228884006\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: American Joint Committee on Cancer cTa (qualifier value)\n <br/>\n \n <em>Code</em>: 1228883000\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Carcinoma in situ of bladder\n <br/>\n \n <em>Code</em>: D09.0\n <br/>\n <em>System</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: virtual\n <br/>\n \n <em>Code</em>: VR\n <br/>\n <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Combined radiotherapy (procedure)\n <br/>\n \n <em>Code</em>: 169331000\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n \n \n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: USQualityCore model information\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <code>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</code>\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: USCore model information\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/us/cql/2026May/Library-USCore-ModelInfo.html\">http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: FHIR model information\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html\">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library SDE\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"Library-SupplementalDataElements.html\">SupplementalDataElements</a> version: 6.1.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|6.1.000</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library FHIRHelpers\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html\">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library USCommon\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/us/cql/2026May/Library-USCoreCommon.html\">http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library FHIRCommon\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRCommon.html\">http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</a>\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library Status\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"Library-Status.html\">Status</a> version: 2.1.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Status|2.1.000</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library USQualityCoreCommon\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: <a href=\"Library-USQualityCoreCommon.html\">US Quality Core Common</a> version: 0.1.0-cibuild\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/USQualityCoreCommon|0.1.0-cibuild</tt>\n \n </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n \n \n\n\n\n\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n \n \n \n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Patient\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: ombCategory, detailed, text\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Patient\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: birthDate\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.354-20250312\">Bladder Cancer for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.351-20250312\">Tuberculosis for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.120.12.1003/expansion\">HIV</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.363-20250312\">Immunocompromised Conditions</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.365-20250312\">Mixed Histology Urothelial Cell Carcinoma for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.354-20250312\">Bladder Cancer for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.351-20250312\">Tuberculosis for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.120.12.1003/expansion\">HIV</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.363-20250312\">Immunocompromised Conditions</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Condition\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.365-20250312\">Mixed Histology Urothelial Cell Carcinoma for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, performed, status, id\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n <a href=\"http://snomed.info/id/254292007\">SNOMED CT: 254292007</a> (Tumor staging (tumor staging))\n \n \n </span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>Path</em>: status</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n [not stated]: completed (completed)\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, performed, status, id\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.358-20250312\">Cystectomy for Urology Care</a>\n <br/> \n \n \n \n \n <span class=\"tab-one\"><em>Path</em>: status</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n [not stated]: completed (completed)\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, performed, status, id\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n <a href=\"http://snomed.info/id/169331000\">SNOMED CT: 169331000</a> (Combined radiotherapy (procedure))\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Medication\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medication.html\">Medication</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: id, code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.353-20250312\">Bacillus Calmette Guerin for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Medication\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medication.html\">Medication</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: id, code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.364-20260205\">Immunosuppressive Drugs for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Medication\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medication.html\">Medication</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: id, code\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.355-20250312\">Chemotherapy Agents for Advanced Cancer</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationAdministration\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medicationadministration.html\">MedicationAdministration</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication.reference, effective, status\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationAdministration\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medicationadministration.html\">MedicationAdministration</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication, effective, status\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: medication</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.353-20250312\">Bacillus Calmette Guerin for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationAdministration\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication, effective, statusReason\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: medication</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.353-20250312\">Bacillus Calmette Guerin for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Observation\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: value, status, reference\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, period, class, status\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a>\n <br/> \n \n \n \n \n <span class=\"tab-one\"><em>Path</em>: class</span>\n <br/>\n \n \n \n \n \n \n <span class=\"tab-one\"><em>Path</em>: status</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n [not stated]: finished (finished)\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Coverage\n <br/>\n \n <em>Profile(s)</em>: \n \n <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage</code>\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationRequest\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medicationrequest.html\">MedicationRequest</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication, dosageInstruction, status, intent\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: medication</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.364-20260205\">Immunosuppressive Drugs for Urology Care</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationRequest\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medicationrequest.html\">MedicationRequest</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication.reference, dosageInstruction, status, intent\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: MedicationRequest\n <br/>\n \n <em>Profile(s)</em>: \n \n <a href=\"http://hl7.org/fhir/R4/medicationrequest.html\">MedicationRequest</a>\n <br/> \n \n \n \n <em>Must Support Elements</em>: medication, dosageInstruction, status, intent\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: medication</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1248.355-20250312\">Chemotherapy Agents for Advanced Cancer</a>\n <br/> \n \n \n \n \n </td>\n</tr>\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n \n \n <tr>\n \n\n<th scope=\"row\" class=\"row-header\"/>\n\n\n <td class=\"content-container\">\n <table>\n <thead>\n <tr>\n <td><em>Name</em></td>\n <td><em>Use</em></td>\n <td><em>Card.</em></td>\n <td><em>Type</em></td>\n <td><em>Documentation</em></td>\n </tr>\n </thead>\n <tbody>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0..1</td>\n <td>Period</td>\n <td/>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0..1</td>\n <td>Coding</td>\n <td/>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0..1</td>\n <td>boolean</td>\n <td/>\n </tr>\n \n <tr>\n <td>Denominator Exception</td>\n <td>Out</td>\n <td>0..1</td>\n <td>boolean</td>\n <td/>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0..1</td>\n <td>boolean</td>\n <td/>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0..*</td>\n <td>Resource</td>\n <td/>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0..1</td>\n <td>boolean</td>\n <td/>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0..1</td>\n <td>Resource</td>\n <td/>\n </tr>\n \n <tr>\n <td>Denominator Exclusion</td>\n <td>Out</td>\n <td>0..1</td>\n <td>boolean</td>\n <td/>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0..1</td>\n <td>Resource</td>\n <td/>\n </tr>\n \n </tbody>\n </table>\n </td>\n</tr>\n\n \n \n\n<tr>\n <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n </tbody>\n </table>\n</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://snomed.info/sct",
"code" : "254292007",
"display" : "Tumor staging (tumor staging)"
}
},
{
"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://snomed.info/sct",
"code" : "1228889001",
"display" : "American Joint Committee on Cancer cT1 (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228884006",
"display" : "American Joint Committee on Cancer cTis (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "1228883000",
"display" : "American Joint Committee on Cancer cTa (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "D09.0",
"display" : "Carcinoma in situ of bladder"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "VR",
"display" : "virtual"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "169331000",
"display" : "Combined radiotherapy (procedure)"
}
},
{
"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" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"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" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Bladder Cancer Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Bladder Cancer Diagnosis\":\n ( [ConditionProblemsHealthConcerns: \"Bladder Cancer for Urology Care\"]\n union [ConditionEncounterDiagnosis: \"Bladder Cancer for Urology Care\"] ) BladderCancer\n where ( BladderCancer.onset.toInterval ( ) starts before day of end of \"Measurement Period\"\n or BladderCancer.onset.toInterval ( ) before day of end of \"Measurement Period\"\n )\n and BladderCancer.isVerified ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "First Bladder Cancer Staging Procedure"
},
{
"url" : "statement",
"valueString" : "define \"First Bladder Cancer Staging Procedure\":\n First([Procedure: \"Tumor staging (tumor staging)\"] BladderCancerStaging\n with \"Bladder Cancer Diagnosis\" BladderCancer\n such that BladderCancerStaging.performed.toInterval() starts on or before day of start of BladderCancer.onset.toInterval ( )\n where BladderCancerStaging.status = 'completed'\n sort by start of performed.toInterval()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "First BCG Administered"
},
{
"url" : "statement",
"valueString" : "define \"First BCG Administered\":\n First([MedicationAdministration: \"Bacillus Calmette Guerin for Urology Care\"] BCG\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that BCG.effective.toInterval() starts 6 months or less after day of start of FirstBladderCancerStaging.performed.toInterval()\n and BCG.effective.toInterval() starts during day of \"Measurement Period\"\n where BCG.status in { 'in-progress', 'completed' }\n sort by start of effective.toInterval()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"First BCG Administered\" is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "BCG Not Available Within 6 Months After Bladder Cancer Staging"
},
{
"url" : "statement",
"valueString" : "define \"BCG Not Available Within 6 Months After Bladder Cancer Staging\":\n [MedicationAdministrationNotDone: \"Bacillus Calmette Guerin for Urology Care\"] BCGNotGiven\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that BCGNotGiven.effective 6 months or less after day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where BCGNotGiven.statusReason in \"Unavailability of Bacillus Calmette Guerin for Urology Care\""
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Denominator Exception"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exception\":\n exists \"BCG Not Available Within 6 Months After Bladder Cancer Staging\""
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "July 1 of Year Prior to the Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"July 1 of Year Prior to the Measurement Period\":\n Date((year from start of \"Measurement Period\" - 1), 7, 1)"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "June 30 of the Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"June 30 of the Measurement Period\":\n Date((year from start of \"Measurement Period\"), 6, 30)"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "First Bladder Cancer Staging Procedure during 6 Months Prior to Measurement Period through the First 6 Months of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"First Bladder Cancer Staging Procedure during 6 Months Prior to Measurement Period through the First 6 Months of Measurement Period\":\n \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n where FirstBladderCancerStaging.performed.toInterval ( ) during day of Interval[\"July 1 of Year Prior to the Measurement Period\", \"June 30 of the Measurement Period\"]"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG"
},
{
"url" : "statement",
"valueString" : "/*Ta High Grade only to be included. Ta low grade is to be excluded from this measure.*/\n\n\ndefine \"Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG\":\n exists ( [LaboratoryResultObservation] StagingObservation\n where StagingObservation.getStagingProcedure ( ) is not null\n and ( StagingObservation.value as CodeableConcept ~ \"American Joint Committee on Cancer cT1 (qualifier value)\"\n or StagingObservation.value as CodeableConcept ~ \"American Joint Committee on Cancer cTis (qualifier value)\"\n or StagingObservation.value as CodeableConcept ~ \"American Joint Committee on Cancer cTa (qualifier value)\"\n or StagingObservation.value as CodeableConcept ~ \"Carcinoma in situ of bladder\"\n )\n and StagingObservation.status in { 'final', 'amended', 'corrected' }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Has Qualifying Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Has Qualifying Encounter\":\n exists ( [Encounter: \"Office Visit\"] ValidEncounter\n where ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.class !~ \"virtual\"\n and ValidEncounter.status = 'finished'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n \"Has Most Recent Bladder Cancer Tumor Staging is T1, Tis, Ta HG\"\n and \"Has Qualifying Encounter\""
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"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" : 15
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"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" : 17
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Acute Tuberculosis Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Acute Tuberculosis Diagnosis\":\n ( [ConditionProblemsHealthConcerns: \"Tuberculosis for Urology Care\"]\n union [ConditionEncounterDiagnosis: \"Tuberculosis for Urology Care\"] ) ActiveTuberculosis\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that ( ( ActiveTuberculosis.onset.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ActiveTuberculosis.onset.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( )\n and ( ( ActiveTuberculosis.abatement.toInterval ( ) overlaps after day of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ActiveTuberculosis.abatement is null )\n )\n )\n )\n where ActiveTuberculosis.isVerified ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Immunosuppressive Drugs"
},
{
"url" : "statement",
"valueString" : "define \"Immunosuppressive Drugs\":\n [MedicationRequest: \"Immunosuppressive Drugs for Urology Care\"] ImmunosuppressiveDrugs\n let firstMedicationPeriod: First((collapse(ImmunosuppressiveDrugs.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n //get the very first event\n \n firstMedicationEvent: First((ImmunosuppressiveDrugs.dosageInstruction.timing dosageTiming\n //return first event for the specific dosageTiming\n \n return First(dosageTiming.event dosageTimingEvents\n sort ascending\n )) firstEvents\n sort ascending\n ),\n medicationPeriod: Coalesce(firstMedicationEvent.toInterval(), firstMedicationPeriod)\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that medicationPeriod starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where ImmunosuppressiveDrugs.status in { 'active', 'completed' }\n and ImmunosuppressiveDrugs.intent = 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Cystectomy Done"
},
{
"url" : "statement",
"valueString" : "define \"Cystectomy Done\":\n [Procedure: \"Cystectomy for Urology Care\"] Cystectomy\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that Cystectomy.performed.toInterval ( ) 6 months or less before day of start of FirstBladderCancerStaging.performed.toInterval ( )\n where Cystectomy.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging"
},
{
"url" : "statement",
"valueString" : "define \"Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging\":\n exists ( ( ( [ConditionProblemsHealthConcerns: \"HIV\"]\n union [ConditionEncounterDiagnosis: \"HIV\"]\n )\n union ( [ConditionProblemsHealthConcerns: \"Immunocompromised Conditions\"]\n union [ConditionEncounterDiagnosis: \"Immunocompromised Conditions\"]\n )\n union ( [ConditionProblemsHealthConcerns: \"Mixed Histology Urothelial Cell Carcinoma for Urology Care\"]\n union [ConditionEncounterDiagnosis: \"Mixed Histology Urothelial Cell Carcinoma for Urology Care\"]\n ) ) ExclusionDiagnosis\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that ( ( ExclusionDiagnosis.onset.toInterval ( ) starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( ) )\n or ( ExclusionDiagnosis.onset.toInterval ( ) starts on or before day of start of FirstBladderCancerStaging.performed.toInterval ( ) )\n )\n where ExclusionDiagnosis.isVerified ( )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging"
},
{
"url" : "statement",
"valueString" : "define \"Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging\":\n exists ( ( [MedicationRequest: \"Chemotherapy Agents for Advanced Cancer\"] ExclusionMed\n let firstMedicationPeriod: First((collapse(ExclusionMed.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n )\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that firstMedicationPeriod starts 6 months or less before FirstBladderCancerStaging.performed.toInterval ( )\n where ExclusionMed.status in { 'active', 'completed' }\n and ExclusionMed.intent = 'order'\n )\n union ( [Procedure: \"Combined radiotherapy (procedure)\"] ExclusionProcedure\n with \"First Bladder Cancer Staging Procedure\" FirstBladderCancerStaging\n such that ExclusionProcedure.performed.toInterval ( ) starts 6 months or less before FirstBladderCancerStaging.performed.toInterval ( )\n where ExclusionProcedure.status in { 'completed', 'in-progress' }\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "Denominator Exclusion"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusion\":\n exists \"Acute Tuberculosis Diagnosis\"\n or exists \"Immunosuppressive Drugs\"\n or exists \"Cystectomy Done\"\n or \"Has Excluding HIV, Immunocompromised Conditions or Mixed Histology Before Staging\"\n or \"Has Excluding Chemotherapy or Radiotherapy Procedure Before Staging\""
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"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" : 25
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"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" : 27
}
],
"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" : 28
}
],
"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" : 29
}
],
"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" : 30
}
],
"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" : 31
}
],
"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" : 32
}
],
"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" : 33
}
],
"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" : 34
}
],
"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" : 35
}
],
"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" : 36
}
],
"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" : 37
}
],
"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" : 38
}
],
"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" : 39
}
],
"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" : 40
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "isVerified"
},
{
"url" : "statement",
"valueString" : "define 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" : 41
}
],
"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" : 42
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value MedicationAdministrationStatus): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS646FHIRIntravesicalBCGTherapy"
},
{
"url" : "name",
"valueString" : "getStagingProcedure"
},
{
"url" : "statement",
"valueString" : "define fluent function getStagingProcedure(StagingObservation LaboratoryResultObservation):\n StagingObservation.partOf StagingReference\n return \"First Bladder Cancer Staging Procedure during 6 Months Prior to Measurement Period through the First 6 Months of Measurement Period\" FirstBladderCancerStagingMP\n where FirstBladderCancerStagingMP.id = StagingReference.reference.getId ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "USQualityCoreCommon"
},
{
"url" : "name",
"valueString" : "getId"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the id of the given uri (i.e. everything after the last slash)\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))"
},
{
"url" : "displaySequence",
"valueInteger" : 45
}
],
"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" : 46
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value EncounterStatus): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 47
}
],
"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" : 48
}
],
"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" : 49
}
],
"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" : 50
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value MedicationRequestStatus): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 51
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value MedicationRequestIntent): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 52
}
],
"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" : 53
}
],
"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" : "Library USQualityCoreCommon",
"resource" : "https://madie.cms.gov/Library/USQualityCoreCommon|0.1.0-cibuild"
},
{
"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 ICD10CM",
"resource" : "http://hl7.org/fhir/sid/icd-10-cm"
},
{
"type" : "depends-on",
"display" : "Code system ActCode",
"resource" : "http://terminology.hl7.org/CodeSystem/v3-ActCode"
},
{
"type" : "depends-on",
"display" : "Value set Bacillus Calmette Guerin for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.353"
},
{
"type" : "depends-on",
"display" : "Value set Bladder Cancer for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.354"
},
{
"type" : "depends-on",
"display" : "Value set Unavailability of Bacillus Calmette Guerin for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.369"
},
{
"type" : "depends-on",
"display" : "Value set Office Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"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 Tuberculosis for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.351"
},
{
"type" : "depends-on",
"display" : "Value set Immunosuppressive Drugs for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.364"
},
{
"type" : "depends-on",
"display" : "Value set Cystectomy for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.358"
},
{
"type" : "depends-on",
"display" : "Value set HIV",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003"
},
{
"type" : "depends-on",
"display" : "Value set Immunocompromised Conditions",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.363"
},
{
"type" : "depends-on",
"display" : "Value set Mixed Histology Urothelial Cell Carcinoma for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.365"
},
{
"type" : "depends-on",
"display" : "Value set Chemotherapy Agents for Advanced Cancer",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.355"
}
],
"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 Exception",
"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" : "Denominator Exclusion",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
}
],
"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/2.16.840.1.113762.1.4.1248.354"
}
]
},
{
"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/2.16.840.1.113762.1.4.1248.351"
}
]
},
{
"type" : "Condition",
"profile" : [
"http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"
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"title" : "Intravesical Bacillus-Calmette-Guerin for Non-Muscle Invasive Bladder CancerFHIR\n",
"status" : "active",
"experimental" : false,
"date" : "2026-01-16T18:18:13+00:00",
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"description" : "Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging\n",
"usage" : "Ta bladder cancer must be high grade Ta only and is supported by the 2016 AUA guidelines and 2018 NCCN guidelines.\n\nThe BCG dose can be full or partial and can be from any lot or manufacturer.\n\nThis eCQM is a patient-based measure.\n\nTelehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS646v6. 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" : "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Oregon Urology Institute (OUI) and Large Urology Group Practice Association (LUGPA) disclaim all liability for the use or accuracy of third-party codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2024. American Medical Association. 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.\n",
"effectivePeriod" : {
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"end" : "2026-12-31"
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"relatedArtifact" : [
{
"type" : "citation",
"citation" : "Chamie, K., Saigal, C.S., Lai, J., Hanley, J.M., Setodji, C.M., Konety, B.R., ... Urologic Diseases in America Project (2011). Compliance with Guidelines for Patients with Bladder Cancer: Variation in the Delivery of Care. Cancer.2011 Dec 1: 117(23): 5392-5401. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206145/\n"
},
{
"type" : "citation",
"citation" : "Chang, S.S., Boorjian, S.A., Chou, R., Clark, P.E., Daneshmand, S., Konety, B.R., ... Mckiernan, J. M., (2016) American Urological Association. Non-Muscle Invasive Bladder Cancer. https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-muscle-invasive-guideline\n"
},
{
"type" : "citation",
"citation" : "Hall, M.C., Chang, S.S., Dalbagni, G., Pruthi, R.S., Schellhammer, P.F., Seigne, J.D., ... Wolf, S., (2016). American Urological Association. Guideline for the Management of Non-muscle Invasive Bladder Cancer (Stages Ta, T1, and Tis): Update 2016. https://www.auajournals.org/doi/10.1016/j.juro.2007.09.003\n"
},
{
"type" : "citation",
"citation" : "Kassouf, W., Black, P., (2016) Treatment of primary non-muscle invasive urothelial bladder cancer. Literature review current through Dec. 2016. https://www.uptodate.com/contents/treatment-of-primary-non-muscle-invasive-urothelial-bladder-cancer?source=search_result\\&search=Treatment%20of%20primary%20non-muscle%20invasive%20urothelial%20bladder%20cancer\\&selectedTitle=1\\~150 T of primary\n"
},
{
"type" : "citation",
"citation" : "National Cancer Institute. (2020). SEER Cancer Stat Facts: Bladder Cancer. Surveillance, Epidemiology, and End Results Program. U.S. Department of Health and Human Services, National Institutes of Health. https://seer.cancer.gov/statfacts/html/urinb.html\n"
},
{
"type" : "citation",
"citation" : "NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). (2021). Bladder Cancer. Version 6.2021. https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf\n"
},
{
"type" : "citation",
"citation" : "Pacific Northwest Evidence-based Practice Center, Oregon Health \\& Science University. (2016). PCORI Topic Brief. Comparative Effectiveness of Treatments for Non-Muscle-Invasive Bladder Cancer http://www.pcori.org/sites/default/files/PCORI-Assessment-Options-Advisory-Panel-Fall-2016-Topic-Brief-Non-Muscle-Invasive-Bladder-Cancer.pdf\n"
}
],
"library" : [
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],
"disclaimer" : "The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\] and unregistered trademarks are indicated by TM or \\[TM\\].\n",
"rationale" : "Bladder cancer is ranked 10th for new cancer cases in 2020 and is the ninth leading cause of cancer death in the United States. There are 81,400 estimated new cases in 2020 and 17,980 estimated deaths in 2020. In 2016, an estimated 699,450 people were living with bladder cancer in the United States. Early detection (discovery of cancer in situ or localized to the primary site) is found in 85% of the patients, and with these there is a five-year survival rate of 95.8% for In Situ and 69.2% for Localized. Bladder cancer is rarely found in patients under age 20, with the median age of diagnosis being 73 (NIH, 2020).\n\nNational Comprehensive Cancer Network (NCCN) Guidelines for Bladder Cancer (version 6.2021) defines intravesical BCG as Category 1 Treatment for T1, Tis and Ta - high grade, non-muscle invasive bladder cancer. Most public data reflects prophylactic or adjuvant use of intravesical therapy to prevent recurrence or delay progression to a higher grade or stage. BCG has been shown to be effective as prophylaxis to prevent bladder cancer recurrences following TURBT. The NCCN Bladder Cancer Panel Members recommend BCG as the preferred option over Mitomycin C for adjuvant treatment of high-grade lesions (Ta). BCG is also standard therapy for Primary Tis. Most T1 lesions are high-risk and are similarly treated with adjuvant intravesical therapy, with BCG being a Category 1 recommendation (NCCN, 2021).\n",
"clinicalRecommendationStatement" : "Intravesical BCG should be administered within 6 months of the initial diagnosis of non-muscle invasive bladder cancer. It may be administered 3-4 weeks after resection, but there needs to be pathological tumor confirmation and must be withheld if there is traumatic catheterization, bacteriuria, persistent gross hematuria, persistent severe local symptoms or systemic symptoms. The normal induction course is 6 weekly instillations of intravesical BCG (AUA Non-Muscle Invasive Bladder Cancer and American Urological Association (AUA) Guideline for the Management of Non-muscle Invasive Bladder Cancer: Stages T1, TIS, and Ta High Risk).\n",
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},
"description" : "Equals Initial Population\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "DenominatorExclusion_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Immunosuppressed patients, includes HIV and immunocompromised state, with a diagnosis prior to Bladder Cancer Staging.\n\nImmunosuppressive drug therapy starting on or before Bladder Cancer Staging.\n\nActive Tuberculosis diagnosis during the Bladder Cancer Staging.\n\nMixed histology urothelial cell carcinoma including micropapillary, plasmacytoid, sarcomatoid, adenocarcinoma and squamous disease prior to Bladder Cancer Staging.\n\nPatients who undergo cystectomy, chemotherapy or radiation within 6 months prior to Bladder Cancer Staging.\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusion"
}
},
{
"id" : "Numerator_1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Intravesical Bacillus-Calmette Guerin (BCG) instillation for initial dose or series: BCG is initiated within 6 months of the bladder cancer staging\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" : "Unavailability of BCG within 6 months after Bladder Cancer Staging\n",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exception"
}
}
]
}
],
"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"
}
}
]
}