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\n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n \n \n \n \n\n\n\n\n \n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n \n \n\n\n\n\n\n\n \n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n\n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n\n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n\n \n \n \n \n\n \n \n\n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n\n \n \n \n \n\n \n \n\n \n \n \n\n \n\n\n \n\n\n\n\n\n\n\n \n \n \n \n \n \n\n\n\n\n\n\n\n\n \n\n\n\n\n \n\n\n\n\n\n\n\n\n\n \n\n\n\n\n \n\n\n\n \n\n\n\n\n \n\n\n\n \n\n\n\n\n \n\n\n\n \n\n\n\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n\n\n\n \n\n\n\n\n\n\n \n \n \n\n \n \n \n \n \n\n\n\n\n\n\n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n \n\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n \n\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n \n\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n \n\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n \n\n \n\n\n \n\n\n \n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n \n\n\n\n\n \n\n\n\n\n\n\n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n\n \n \n \n\n\n\n\n \n \n\n \n\n\n\n \n \n \n\n\n\n\n \n \n\n \n\n\n\n \n \n \n\n\n\n\n \n \n\n \n\n\n\n \n \n \n\n\n\n\n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n\n \n \n\n\n\n\n \n \n \n\n \n\n\n \n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n \n \n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n \n \n\n\n\n\n\n\n \n\n\n\n\n\n\n \n \n \n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n \n \n\n\n 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Metadata
TitleKidney Health EvaluationFHIR\n
Version1.0.000
Short NameCMS951FHIR
GUID (Version Independent)urn:uuid:e66e345d-d892-4fe2-84a7-748433b6e0a6
GUID (Version Specific)urn:uuid:fc073788-dfa7-4163-a352-68d0fbdd99c8
CMS Identifier951FHIR
Effective Period2026-01-01 through 2026-12-31
Steward (Publisher)National Kidney Foundation
DeveloperNational Kidney Foundation
Description

Percentage of patients aged 18-85 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period

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Copyright

Copyright 2025 National Kidney Foundation. All Rights Reserved.

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Disclaimer

Physician Performance Measures (Measures) and related data specifications developed by the National Kidney Foundation (NKF) are intended to facilitate quality improvement activities by health care professionals.

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These Measures are intended to assist health care professionals in enhancing quality of care. These Measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. NKF encourages testing and evaluation of its Measures.

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Measures are subject to review and may be revised or rescinded at any time by NKF. The measures may not be altered without prior written approval from NKF. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed, or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and NKF. Neither NKF nor its members shall be responsible for any use of the measures.

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THESE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

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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.

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CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is 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 is copyright 2024 World Health Organization. All Rights Reserved.

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The PCPI's and AMA's significant past efforts and contributions to the development and updating of the measure are acknowledged.

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Due to technical limitations, registered trademarks are indicated by (R) or [R].

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Rationale

Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2022), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes---the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018).

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The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual's lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes.

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Clinical Recommendation Statement

The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable:

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At least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023)

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Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence:

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    5 years after the diagnosis of type 1 diabetes; (A) or

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    From diagnosis of type 2 diabetes. (B)

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    <br />

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Screening should include:

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    Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B)

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    Measurement of serum creatinine and estimation of GFR. (B)

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(NKF, 2007; NKF, 2012)

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Citation\n \n \n \n

Alfego, D., Ennis, J., Gillespie, B., Lewis, M.J., Montgomery, E., Ferre, S., ... Letovsky, S. (2021). Chronic kidney disease testing among at-risk adults in the U.S. remains low: Real-world evidence from a National Laboratory database. Diabetes Care, 44(9), 2025-2032. https://doi.org/10.2337/dc21-0723

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Citation\n \n \n \n

American Diabetes Association Professional Practice Committee. (2023). Chronic kidney disease and risk management: Standards of medical care in diabetes-2023. Diabetes Care, 46(Supplement_1), S191-S202. https://doi.org/10.2337/dc23-S011

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Citation\n \n \n \n

Nichols, G.A, Ustyugova, A., Deruaz-Luyet, A., O'Keeffe-Rosetti, M., & Brodovicz, K.G. (2020). Health care costs by type of expenditure across eGFR stages among patients with and without diabetes, cardiovascular disease, and heart failure. JASN, 31(7), 1594-1601. https://doi.org/10.1681/asn.2019121308

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Citation\n \n \n \n

Saran R. B., Abbott K. C., ..., Zhang, X. (2019). US renal data system 2018 annual data report: Epidemiology of kidney disease in the United States. American Journal of Kidney Diseases, 73(3), Svii-Sxxii. https://doi.org/10.1053/j.ajkd.2019.01.001

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Citation\n \n \n \n

Stempneiwicz, N., Vassalotti, J.A., Cuddeback, J.K., Ciemins, E., Storfer-Isser, A., Sang, Y., ... Coresh, J. (2021). Chronic kidney disease testing among primary care patients with type 2 diabetes across 24 U.S. health care organizations. Diabetes Care, 44(9), 2000-2009. https://doi.org/10.2337/dc20-2715

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Citation\n \n \n \n

Szczech, L. A., Stewart, R. C., Su, H., Deloskey, R. J., Astor, B. C., Fox, C. H., ... Vassalotti, J. A. (2014). Primary care detection of chronic kidney disease in adults with type-2 diabetes: The ADD-CKD study (Awareness, detection and drug therapy in type 2 diabetes and chronic kidney disease). PLoS ONE, 9(11), e110535. https://doi.org/10.1371/journal.pone.0110535

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Citation\n \n \n \n

Bowe, B., Xie, Y., Li, T., Mokdad, A. H., Xian, H., Yan, Y.,... Al-Aly, Z. (2018). Changes in the US burden of chronic kidney disease from 2002 to 2016. JAMA Network Open, 1(7). doi: 10.1001/jamanetworkopen.2018.4412

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Citation\n \n \n \n

Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States. (2023). Retrieved from: https://www.cdc.gov/kidney-disease/php/data-research/?CDC_AAref_Val=https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html

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Citation\n \n \n \n

de Boer, I.H., Khunti, K., Sadusky, T., Tuttle, K.R., Neumiller, J.J., Rhee, Bakris, G. (2022). Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Kidney International, 102(5):974-989. doi: 10.1016/j.kint.2022.08.012

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Citation\n \n \n \n

Healthy People 2030. Retrieved from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/chronic-kidney-disease

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Citation\n \n \n \n

Hoerger, T. J., Simpson, S. A., Yarnoff, B. O., Pavkov, M. E., Burrows, N. R., Saydah, S. H., . . . Zhuo, X. (2015). The future burden of CKD in the United States: A simulation model for the CDC CKD Initiative. American Journal of Kidney Diseases, 65(3), 403-411. doi:10.1053/j.ajkd.2014.09.023

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Citation\n \n \n \n

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S): S117--S314.

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Citation\n \n \n \n

National Kidney Foundation. (2007). KDOQI Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Retrieved from: https://www.kidney.org/sites/default/files/docs/diabetes_ajkd_febsuppl_07.pdf

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Citation\n \n \n \n

National Kidney Foundation. (2022). About chronic kidney disease. Retrieved from: https://www.kidney.org/atoz/content/about-chronic-kidney-disease

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Guidance (Usage)This measure assesses the performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age).\n\nThe Urine Albumin-Creatinine Ratio (uACR) requirement can be met with a documented Urine Albumin and Urine Creatine conducted on the same urine sample AND reported less than or equal to four days apart. A calculation of uACR is not required to meet this measure, but it is intended to for the uACR to be calculated for the purposes of kidney health evaluation. If the Urine Albumin and Urine Creatine tests have different units of measure, they should be converted to the same unit of measure for the purposes of calculating uACR.\n\nThe Urine Albumin Creatinine Ratio Test requirement can be met if the lab result is received as a quantitative value or as an undetectable result. Undetectable results can be coded using values in the "Undetectable Lab Result Value" value set.\n\nThis dQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS951v4.\n\nPlease 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
Measure Group (Rate) (ID: Group_1)
Basisboolean
Scoring\n Proportion\n\n\n
Improvement Notation\n Increased score indicates improvement\n\n\n
Type\n Process\n\n\n
Rate AggregationNone\n
Initial Population\n \n ID: InitialPopulation_1\n
\n \n \n Description:\n

All patients aged 18-85 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period\n

\n \n \n \n \n \n Criteria: Initial Population \n \n \n \n \n \n \n
Denominator\n \n ID: Denominator_1\n
\n \n \n Description:\n

Equals Initial Population\n

\n \n \n \n \n \n Criteria: Denominator \n \n \n \n \n \n \n
Denominator Exclusion\n \n ID: DenominatorExclusion_1\n
\n \n \n Description:\n

Patients with a diagnosis of ESRD active during the measurement period; \n\nPatients with a diagnosis of CKD Stage 5 active during the measurement period; \n\nPatients who have an order for or are receiving hospice or palliative care.\n

\n \n \n \n \n \n Criteria: Denominator Exclusions \n \n \n \n \n \n \n
Numerator\n \n ID: Numerator_1\n
\n \n \n Description:\n

Patients who received a kidney health evaluation during the measurement period. Kidney health evaluation is defined by an eGFR AND uACR within the measurement period OR an eGFR and a Urine Albumin and Urine Creatine result documented less than or equal to four days apart\n

\n \n \n \n \n \n Criteria: Numerator \n \n \n \n \n \n \n
\n\n\n\nFor every patient evaluated by this measure also identify payer, race, ethnicity and sex
Supplemental Data Elements
Supplemental Data Element\n \n ID: sde-ethnicity\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Ethnicity\n\n \n \n \n
\n \n \n Logic Definition: SDE Ethnicity \n \n \n \n
Supplemental Data Element\n \n ID: sde-payer\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Payer\n\n \n \n \n
\n \n \n Logic Definition: SDE Payer \n \n \n \n
Supplemental Data Element\n \n ID: sde-race\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Race\n\n \n \n \n
\n \n \n Logic Definition: SDE Race \n \n \n \n
Supplemental Data Element\n \n ID: sde-sex\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Sex\n\n \n \n \n
\n \n \n Logic Definition: SDE Sex \n \n \n \n
Measure Logic
Primary Libraryhttps://madie.cms.gov/Library/CMS951FHIRKidneyHealthEval
Contents\n Population Criteria\n
\n Logic Definitions\n
\n Terminology\n
\n Dependencies\n
\n Data Requirements\n
\n Parameters\n
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Population Criteria
Measure Group (Rate) (ID: Group_1)
\n \n Initial Population\n \n
\n \n \n \n \n \n \n \n 
define "Initial Population":\n  AgeInYearsAt(date from start of "Measurement Period") in Interval[18, 85]\n    and "Has Active Diabetes Overlaps Start Of Measurement Period"\n    and "Has Outpatient Visit During Measurement Period"
\n \n \n Definition\n \n
\n \n Denominator\n \n
\n \n \n \n \n \n \n \n 
define "Denominator":\n  "Initial Population"
\n \n \n Definition\n \n
\n \n Denominator Exclusion\n \n
\n \n \n \n \n \n \n \n 
define "Denominator Exclusions":\n  "Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period"\n    or Hospice."Has Hospice Services"\n    or PalliativeCare."Has Palliative Care in the Measurement Period"
\n \n \n Definition\n \n
\n \n Numerator\n \n
\n \n \n \n \n \n \n \n 
define "Numerator":\n  "Kidney Panel Performed During Measurement Period"
\n \n \n Definition\n \n
Logic Definitions
\n Logic Definition\n Library Name: Hospice
\n \n \n \n \n \n \n 
define "Has Hospice Services":\n  exists ((([USQualityCore.Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter\n      where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"\n          or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"\n      )\n        and InpatientEncounter.period ends during day of "Measurement Period"\n  )\n    or exists ((([USQualityCore.Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter\n        where HospiceEncounter.period overlaps day of "Measurement Period"\n    )\n    // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)\n    or exists ((([USQualityCore.ObservationScreeningAssessment: code ~ "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment\n        where HospiceAssessment.value ~ "Yes (qualifier value)"\n          and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"\n    )\n    or exists ((([USQualityCore.ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder\n        where HospiceOrder.authoredOn during day of "Measurement Period"\n    )\n    or exists ((([USQualityCore.Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed\n        where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"\n    )\n    // TODO: Consider whether to keep this as the union of Problems and EncounterDiagnosis\n    or exists ((([FHIR.Condition: "Hospice Diagnosis"]).verified()) HospiceCareDiagnosis\n        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"\n    )
\n
\n Logic Definition\n Library Name: PalliativeCare
\n \n \n \n \n \n \n 
define "Has Palliative Care in the Measurement Period":\n  // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)\n  exists ((([USQualityCore.ObservationScreeningAssessment: code ~ "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment\n      where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"\n  )\n    // TODO: Consider whether to keep this as the union of the problems and encounter diagnosis list? Anything enforced by the profiles that is expected but isn't stated here?\n    or exists ((([FHIR.Condition: "Palliative Care Diagnosis"]).verified()) PalliativeDiagnosis\n        where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"\n    )\n    or exists ((([USQualityCore.Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter\n        where PalliativeEncounter.period overlaps day of "Measurement Period"\n    )\n    or exists ((([USQualityCore.Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention\n        where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"\n    )
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
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
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Payer":\n  [USQualityCore.Coverage: type in "Payer Type"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Ethnicity":\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Race":\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "SDE Sex":\n  SDE."SDE Sex"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has Estimated Glomerular Filtration Rate Performed During Measurement Period":\n  exists ( ["LaboratoryResultObservation": "Estimated Glomerular Filtration Rate"] eGFRTest\n      where eGFRTest.effective.toInterval ( ) during day of "Measurement Period"\n        and eGFRTest.value is not null\n        and eGFRTest.status in { 'final', 'amended', 'corrected' }\n  )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has Urine Albumin Creatinine Ratio Test Performed During Measurement Period":\n  exists ( ["LaboratoryResultObservation": "Urine Albumin Creatinine Ratio"] uACRTest\n      where uACRTest.effective.toInterval ( ) during day of "Measurement Period"\n        and uACRTest.status in { 'final', 'amended', 'corrected' }\n        and ( ( uACRTest.value is Quantity )\n            or ( uACRTest.value as FHIR.CodeableConcept in "Undetectable Lab Result Value" )\n        )\n  )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Urine Albumin Test Performed During The Measurement Period":\n  ["LaboratoryResultObservation": "Urine Albumin"] AlbuminTest\n    where AlbuminTest.effective.toInterval ( ) during day of "Measurement Period"\n      and AlbuminTest.value is not null\n      and AlbuminTest.status in { 'final', 'amended', 'corrected' }
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Urine Creatinine Test Performed During The Measurement Period":\n  ["LaboratoryResultObservation": "Urine Creatinine"] CreatinineTest\n    where CreatinineTest.effective.toInterval ( ) during day of "Measurement Period"\n      and CreatinineTest.value is not null\n      and CreatinineTest.status in { 'final', 'amended', 'corrected' }
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has Urine Albumin Test And Urine Creatine Test Less Than Or Equal To Four Days Apart":\n  exists ( from\n      "Urine Albumin Test Performed During The Measurement Period" UrineAlbuminTest,\n      "Urine Creatinine Test Performed During The Measurement Period" UrineCreatinineTest\n      let UrineAlbuminDocumentedTime: UrineAlbuminTest.effective.toInterval ( ),\n      UrineCreatinineDocumentedTime: UrineCreatinineTest.effective.toInterval ( )\n      where UrineAlbuminDocumentedTime during Interval[start of UrineCreatinineDocumentedTime - 4 days, end of UrineCreatinineDocumentedTime + 4 days]\n  )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Kidney Panel Performed During Measurement Period":\n  "Has Estimated Glomerular Filtration Rate Performed During Measurement Period"\n    and ( "Has Urine Albumin Creatinine Ratio Test Performed During Measurement Period"\n        or "Has Urine Albumin Test And Urine Creatine Test Less Than Or Equal To Four Days Apart"\n    )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Numerator":\n  "Kidney Panel Performed During Measurement Period"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has Active Diabetes Overlaps Start Of Measurement Period":\n  exists ( ["ConditionProblemsHealthConcerns": "Diabetes"]\n    union ["ConditionEncounterDiagnosis": "Diabetes"] ) DiabetesDiagnosis\n    where DiabetesDiagnosis.onset.toInterval ( ) overlaps before day of "Measurement Period"\n      and ( DiabetesDiagnosis.verificationStatus is not null implies ( DiabetesDiagnosis.verificationStatus !~ Status."refuted"\n            and DiabetesDiagnosis.verificationStatus !~ Status."entered-in-error"\n        )\n      )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has Outpatient Visit During Measurement Period":\n  exists ( ( ["Encounter": "Annual Wellness Visit"]\n      union ["Encounter": "Home Healthcare Services"]\n      union ["Encounter": "Office Visit"]\n      union ["Encounter": "Outpatient Consultation"]\n      union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]\n      union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]\n      union ["Encounter": "Telephone Visits"] ) ValidEncounter\n      where ValidEncounter.period during day of "Measurement Period"\n        and ValidEncounter.status = 'finished'\n  )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Initial Population":\n  AgeInYearsAt(date from start of "Measurement Period") in Interval[18, 85]\n    and "Has Active Diabetes Overlaps Start Of Measurement Period"\n    and "Has Outpatient Visit During Measurement Period"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Denominator":\n  "Initial Population"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "SDE Payer":\n  SDE."SDE Payer"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "SDE Ethnicity":\n  SDE."SDE Ethnicity"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period":\n  exists ( ( ["ConditionProblemsHealthConcerns": "Chronic Kidney Disease, Stage 5"]\n      union ["ConditionEncounterDiagnosis": "Chronic Kidney Disease, Stage 5"]\n  )\n    union ( ["ConditionProblemsHealthConcerns": "End Stage Renal Disease"]\n        union ["ConditionEncounterDiagnosis": "End Stage Renal Disease"]\n    ) ) CKDOrESRD\n    where CKDOrESRD.onset.toInterval ( ) overlaps day of "Measurement Period"\n      and ( CKDOrESRD.verificationStatus is not null implies ( CKDOrESRD.verificationStatus !~ Status."refuted"\n            and CKDOrESRD.verificationStatus !~ Status."entered-in-error"\n        )\n      )
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "Denominator Exclusions":\n  "Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period"\n    or Hospice."Has Hospice Services"\n    or PalliativeCare."Has Palliative Care in the Measurement Period"
\n
\n Logic Definition\n Library Name: CMS951FHIRKidneyHealthEval
\n \n \n \n \n \n \n 
define "SDE Race":\n  SDE."SDE Race"
\n
\n Logic Definition\n Library Name: Status
\n \n \n \n \n \n \n 
//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List<FHIR.Encounter>):\n  Enc E\n    where E.status = 'finished'
\n
\n Logic Definition\n Library Name: Status
\n \n \n \n \n \n \n 
//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }
\n
\n Logic Definition\n Library Name: Status
\n \n \n \n \n \n \n 
//Intervention, Order\ndefine fluent function isInterventionOrder(ServiceRequest List<FHIR.ServiceRequest>):\n  ServiceRequest S\n    where S.status in { 'active', 'completed' }\n      and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
\n
\n Logic Definition\n Library Name: Status
\n \n \n \n \n \n \n 
//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List<FHIR.Procedure>):\n  Proc P\n    where P.status ~ 'completed'
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value string): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value uri): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDateTime(value dateTime): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\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]
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDateTime(value instant): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDate(value date): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value ObservationStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\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        }
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\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        }
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value EncounterStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value ServiceRequestStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value ServiceRequestIntent): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value ProcedureStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\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)
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\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)
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential\n*/\ndefine fluent function verified(conditions List<FHIR.Condition>):\n  conditions C\n    where C.verificationStatus is not null implies\n      (C.verificationStatus ~ "confirmed"\n        or C.verificationStatus ~ "unconfirmed"\n        or C.verificationStatus ~ "provisional"\n        or C.verificationStatus ~ "differential"\n      )
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ "active"\n  or condition.clinicalStatus ~ "recurrence"\n  or condition.clinicalStatus ~ "relapse" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n  (end of condition.abatementInterval()) abatementDate\n    return \n\t  if abatementDate is null then\n        Interval[start of condition.onset.toInterval(), abatementDate)\n      else\n        Interval[start of condition.onset.toInterval(), abatementDate]
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n  if condition.abatement is FHIR.dateTime then\n    Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n  else if condition.abatement is FHIR.Period then\n    FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n  else if condition.abatement is FHIR.string then\n    Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n  else if condition.abatement is FHIR.Age then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n  else if condition.abatement is FHIR.Range then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n  else if condition.abatement is FHIR.boolean then\n    Interval[end of condition.onset.toInterval(), condition.recordedDate)\n  else \n    null
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
/*\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
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
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    }
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
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    }
\n
Terminology
Code System\n \n Description: Code system SNOMEDCT\n \n
\n \n \n \n \n \n \n Resource: SNOMED CT (all versions)\n
\n Canonical URL: http://snomed.info/sct\n \n
Code System\n \n Description: Code system ConditionVerificationStatusCodes\n \n
\n \n \n \n \n \n \n Resource: ConditionVerificationStatus\n
\n Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status\n \n
Code System\n \n Description: Code system LOINC\n \n
\n \n \n \n \n \n \n Resource: Logical Observation Identifiers, Names and Codes (LOINC)\n
\n Canonical URL: http://loinc.org\n \n
Code System\n \n Description: Code system ConditionClinicalStatusCodes\n \n
\n \n \n \n \n \n \n Resource: Condition Clinical Status Codes\n
\n Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical\n \n
Value Set\n \n Description: Value set Estimated Glomerular Filtration Rate\n \n
\n \n \n \n \n \n \n Resource: Estimated Glomerular Filtration Rate\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1000\n \n
Value Set\n \n Description: Value set Urine Albumin Creatinine Ratio\n \n
\n \n \n \n \n \n \n Resource: Urine Albumin Creatinine Ratio\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1007\n \n
Value Set\n \n Description: Value set Undetectable Lab Result Value\n \n
\n \n \n \n \n \n \n Resource: Undetectable Lab Result Value\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.272\n \n
Value Set\n \n Description: Value set Urine Albumin\n \n
\n \n \n \n \n \n \n Resource: Urine Albumin\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.88\n \n
Value Set\n \n Description: Value set Urine Creatinine\n \n
\n \n \n \n \n \n \n Resource: Urine Creatinine\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.87\n \n
Value Set\n \n Description: Value set Diabetes\n \n
\n \n \n \n \n \n \n Resource: Diabetes\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001\n \n
Value Set\n \n Description: Value set Annual Wellness Visit\n \n
\n \n \n \n \n \n \n Resource: Annual Wellness Visit\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240\n \n
Value Set\n \n Description: Value set Home Healthcare Services\n \n
\n \n \n \n \n \n \n Resource: Home Healthcare Services\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016\n \n
Value Set\n \n Description: Value set Office Visit\n \n
\n \n \n \n \n \n \n Resource: Office Visit\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001\n \n
Value Set\n \n Description: Value set Outpatient Consultation\n \n
\n \n \n \n \n \n \n Resource: Outpatient Consultation\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008\n \n
Value Set\n \n Description: Value set Preventive Care Services Established Office Visit, 18 and Up\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services Established Office Visit, 18 and Up\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025\n \n
Value Set\n \n Description: Value set Preventive Care Services Initial Office Visit, 18 and Up\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services Initial Office Visit, 18 and Up\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023\n \n
Value Set\n \n Description: Value set Telephone Visits\n \n
\n \n \n \n \n \n \n Resource: Telephone Visits\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080\n \n
Value Set\n \n Description: Value set Payer Type\n \n
\n \n \n \n \n \n \n Resource: Payer Type\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n \n
Value Set\n \n Description: Value set Chronic Kidney Disease, Stage 5\n \n
\n \n \n \n \n \n \n Resource: Chronic Kidney Disease, Stage 5\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002\n \n
Value Set\n \n Description: Value set End Stage Renal Disease\n \n
\n \n \n \n \n \n \n Resource: End Stage Renal Disease\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353\n \n
Value Set\n \n Description: Value set Encounter Inpatient\n \n
\n \n \n \n \n \n \n Resource: Encounter Inpatient\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307\n \n
Value Set\n \n Description: Value set Hospice Encounter\n \n
\n \n \n \n \n \n \n Resource: Hospice Encounter\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003\n \n
Value Set\n \n Description: Value set Hospice Care Ambulatory\n \n
\n \n \n \n \n \n \n Resource: Hospice Care Ambulatory\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584\n \n
Value Set\n \n Description: Value set Hospice Diagnosis\n \n
\n \n \n \n \n \n \n Resource: Hospice Diagnosis\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165\n \n
Value Set\n \n Description: Value set Palliative Care Diagnosis\n \n
\n \n \n \n \n \n \n Resource: Palliative Care Diagnosis\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167\n \n
Value Set\n \n Description: Value set Palliative Care Encounter\n \n
\n \n \n \n \n \n \n Resource: Palliative Care Encounter\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090\n \n
Value Set\n \n Description: Value set Palliative Care Intervention\n \n
\n \n \n \n \n \n \n Resource: Palliative Care Intervention\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135\n \n
Direct Reference Code\n \n Display: Male (finding)\n
\n \n Code: 248153007\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: Female (finding)\n
\n \n Code: 248152002\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: refuted\n
\n \n Code: refuted\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Display: entered-in-error\n
\n \n Code: entered-in-error\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Display: Discharge to home for hospice care (procedure)\n
\n \n Code: 428361000124107\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: Discharge to healthcare facility for hospice care (procedure)\n
\n \n Code: 428371000124100\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: Yes (qualifier value)\n
\n \n Code: 373066001\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: Hospice care [Minimum Data Set]\n
\n \n Code: 45755-6\n
\n System: http://loinc.org\n
Direct Reference Code\n \n Code: confirmed\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Code: unconfirmed\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Code: provisional\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Code: differential\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Code: active\n
\n System: http://terminology.hl7.org/CodeSystem/condition-clinical\n
Direct Reference Code\n \n Code: recurrence\n
\n System: http://terminology.hl7.org/CodeSystem/condition-clinical\n
Direct Reference Code\n \n Code: relapse\n
\n System: http://terminology.hl7.org/CodeSystem/condition-clinical\n
Direct Reference Code\n \n Display: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)\n
\n \n Code: 71007-9\n
\n System: http://loinc.org\n
Dependencies
Dependency\n \n Description: USQualityCore model information\n \n
\n \n \n \n \n \n \n Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild\n
\n Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild\n \n
Dependency\n \n Description: USCore model information\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived\n
\n Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived\n \n
Dependency\n \n Description: FHIR model information\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n \n
Dependency\n \n Description: Library SDE\n \n
\n \n \n \n \n \n \n Resource: SupplementalDataElements version: 6.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000\n \n
Dependency\n \n Description: Library FHIRHelpers\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1\n \n
Dependency\n \n Description: Library USCommon\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot\n
\n Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot\n \n
Dependency\n \n Description: Library FHIRCommon\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0\n \n
Dependency\n \n Description: Library Status\n \n
\n \n \n \n \n \n \n Resource: Status version: 2.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/Status|2.1.000\n \n
Dependency\n \n Description: Library Hospice\n \n
\n \n \n \n \n \n \n Resource: Hospice version: 7.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/Hospice|7.1.000\n \n
Dependency\n \n Description: Library PalliativeCare\n \n
\n \n \n \n \n \n \n Resource: PalliativeCare version: 2.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/PalliativeCare|2.1.000\n \n
Data Requirements
Data Requirement\n Type: Patient\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient\n
\n \n \n \n Must Support Elements: ombCategory, detailed, text\n
\n \n \n
Data Requirement\n Type: Patient\n
\n \n Profile(s): \n \n Patient\n
\n \n \n \n Must Support Elements: birthDate\n
\n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab\n
\n \n \n \n Must Support Elements: code, effective, value, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Estimated Glomerular Filtration Rate\n
\n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab\n
\n \n \n \n Must Support Elements: code, effective, status, value\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Urine Albumin Creatinine Ratio\n
\n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab\n
\n \n \n \n Must Support Elements: code, effective, value, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Urine Albumin\n
\n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab\n
\n \n \n \n Must Support Elements: code, effective, value, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Urine Creatinine\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Diabetes\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Chronic Kidney Disease, Stage 5\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: End Stage Renal Disease\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Diabetes\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Chronic Kidney Disease, Stage 5\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: End Stage Renal Disease\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Annual Wellness Visit\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Home Healthcare Services\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Office Visit\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Outpatient Consultation\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services Established Office Visit, 18 and Up\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services Initial Office Visit, 18 and Up\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Telephone Visits\n
\n \n \n \n \n
Data Requirement\n Type: Coverage\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage\n
\n \n \n \n Must Support Elements: type, period\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Payer Type\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n Condition\n
\n \n \n \n Must Support Elements: abatement, verificationStatus, onset, recordedDate, clinicalStatus\n
\n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n Condition\n
\n \n \n \n Must Support Elements: code, verificationStatus\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Hospice Diagnosis\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n Condition\n
\n \n \n \n Must Support Elements: code, verificationStatus\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Palliative Care Diagnosis\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter\n
\n \n \n \n Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Encounter Inpatient\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter\n
\n \n \n \n Must Support Elements: type, period\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Hospice Encounter\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter\n
\n \n \n \n Must Support Elements: type, period\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Palliative Care Encounter\n
\n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment\n
\n \n \n \n Must Support Elements: code, value, effective, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n \n Code(s): \n \n \n LOINC: 45755-6 (Hospice care [Minimum Data Set])\n \n \n \n
\n \n \n \n Path: value\n
\n \n \n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment\n
\n \n \n \n Must Support Elements: code, effective, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n \n Code(s): \n \n \n LOINC: 71007-9 (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal))\n \n \n \n
\n \n \n \n
Data Requirement\n Type: ServiceRequest\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest\n
\n \n \n \n Must Support Elements: code, authoredOn\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Hospice Care Ambulatory\n
\n \n \n \n \n
Data Requirement\n Type: Procedure\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure\n
\n \n \n \n Must Support Elements: code, performed\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Hospice Care Ambulatory\n
\n \n \n \n \n
Data Requirement\n Type: Procedure\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure\n
\n \n \n \n Must Support Elements: code, performed\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: Palliative Care Intervention\n
\n \n \n \n \n
Parameters
\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
NameUseCard.TypeDocumentation
Measurement PeriodIn0..1Period\n
SDE SexOut0..1Coding\n
NumeratorOut0..1boolean\n
DenominatorOut0..1boolean\n
SDE PayerOut0..*Resource\n
Initial PopulationOut0..1boolean\n
SDE EthnicityOut0..1Resource\n
Denominator ExclusionsOut0..1boolean\n
SDE RaceOut0..1Resource\n
\n
Generated using version 0.5.4 of the sample-content-ig Liquid templates
\n
" }, "contained" : [{ "resourceType" : "Library", "id" : "effective-data-requirements", "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "248153007", "display" : "Male (finding)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "248152002", "display" : "Female (finding)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "refuted", "display" : "refuted" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "entered-in-error", "display" : "entered-in-error" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "428361000124107", "display" : "Discharge to home for hospice care (procedure)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "428371000124100", "display" : "Discharge to healthcare facility for hospice care (procedure)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Yes (qualifier value)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://loinc.org", "code" : "45755-6", "display" : "Hospice care [Minimum Data Set]" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "confirmed" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "unconfirmed" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "provisional" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "differential" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "active" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "recurrence" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "relapse" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://loinc.org", "code" : "71007-9", "display" : "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)" } }, { "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" : "CMS951FHIRKidneyHealthEval" }, { "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" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has Estimated Glomerular Filtration Rate Performed During Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Estimated Glomerular Filtration Rate Performed During Measurement Period\":\n exists ( [\"LaboratoryResultObservation\": \"Estimated Glomerular Filtration Rate\"] eGFRTest\n where eGFRTest.effective.toInterval ( ) during day of \"Measurement Period\"\n and eGFRTest.value is not null\n and eGFRTest.status in { 'final', 'amended', 'corrected' }\n )" }, { "url" : "displaySequence", "valueInteger" : 2 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has Urine Albumin Creatinine Ratio Test Performed During Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Urine Albumin Creatinine Ratio Test Performed During Measurement Period\":\n exists ( [\"LaboratoryResultObservation\": \"Urine Albumin Creatinine Ratio\"] uACRTest\n where uACRTest.effective.toInterval ( ) during day of \"Measurement Period\"\n and uACRTest.status in { 'final', 'amended', 'corrected' }\n and ( ( uACRTest.value is Quantity )\n or ( uACRTest.value as FHIR.CodeableConcept in \"Undetectable Lab Result Value\" )\n )\n )" }, { "url" : "displaySequence", "valueInteger" : 3 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Urine Albumin Test Performed During The Measurement Period" }, { "url" : "statement", "valueString" : "define \"Urine Albumin Test Performed During The Measurement Period\":\n [\"LaboratoryResultObservation\": \"Urine Albumin\"] AlbuminTest\n where AlbuminTest.effective.toInterval ( ) during day of \"Measurement Period\"\n and AlbuminTest.value is not null\n and AlbuminTest.status in { 'final', 'amended', 'corrected' }" }, { "url" : "displaySequence", "valueInteger" : 4 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Urine Creatinine Test Performed During The Measurement Period" }, { "url" : "statement", "valueString" : "define \"Urine Creatinine Test Performed During The Measurement Period\":\n [\"LaboratoryResultObservation\": \"Urine Creatinine\"] CreatinineTest\n where CreatinineTest.effective.toInterval ( ) during day of \"Measurement Period\"\n and CreatinineTest.value is not null\n and CreatinineTest.status in { 'final', 'amended', 'corrected' }" }, { "url" : "displaySequence", "valueInteger" : 5 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has Urine Albumin Test And Urine Creatine Test Less Than Or Equal To Four Days Apart" }, { "url" : "statement", "valueString" : "define \"Has Urine Albumin Test And Urine Creatine Test Less Than Or Equal To Four Days Apart\":\n exists ( from\n \"Urine Albumin Test Performed During The Measurement Period\" UrineAlbuminTest,\n \"Urine Creatinine Test Performed During The Measurement Period\" UrineCreatinineTest\n let UrineAlbuminDocumentedTime: UrineAlbuminTest.effective.toInterval ( ),\n UrineCreatinineDocumentedTime: UrineCreatinineTest.effective.toInterval ( )\n where UrineAlbuminDocumentedTime during Interval[start of UrineCreatinineDocumentedTime - 4 days, end of UrineCreatinineDocumentedTime + 4 days]\n )" }, { "url" : "displaySequence", "valueInteger" : 6 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Kidney Panel Performed During Measurement Period" }, { "url" : "statement", "valueString" : "define \"Kidney Panel Performed During Measurement Period\":\n \"Has Estimated Glomerular Filtration Rate Performed During Measurement Period\"\n and ( \"Has Urine Albumin Creatinine Ratio Test Performed During Measurement Period\"\n or \"Has Urine Albumin Test And Urine Creatine Test Less Than Or Equal To Four Days Apart\"\n )" }, { "url" : "displaySequence", "valueInteger" : 7 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Numerator" }, { "url" : "statement", "valueString" : "define \"Numerator\":\n \"Kidney Panel Performed During Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 8 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has Active Diabetes Overlaps Start Of Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Active Diabetes Overlaps Start Of Measurement Period\":\n exists ( [\"ConditionProblemsHealthConcerns\": \"Diabetes\"]\n union [\"ConditionEncounterDiagnosis\": \"Diabetes\"] ) DiabetesDiagnosis\n where DiabetesDiagnosis.onset.toInterval ( ) overlaps before day of \"Measurement Period\"\n and ( DiabetesDiagnosis.verificationStatus is not null implies ( DiabetesDiagnosis.verificationStatus !~ Status.\"refuted\"\n and DiabetesDiagnosis.verificationStatus !~ Status.\"entered-in-error\"\n )\n )" }, { "url" : "displaySequence", "valueInteger" : 9 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has Outpatient Visit During Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Outpatient Visit During Measurement Period\":\n exists ( ( [\"Encounter\": \"Annual Wellness Visit\"]\n union [\"Encounter\": \"Home Healthcare Services\"]\n union [\"Encounter\": \"Office Visit\"]\n union [\"Encounter\": \"Outpatient Consultation\"]\n union [\"Encounter\": \"Preventive Care Services Established Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Telephone Visits\"] ) ValidEncounter\n where ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.status = 'finished'\n )" }, { "url" : "displaySequence", "valueInteger" : 10 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Initial Population" }, { "url" : "statement", "valueString" : "define \"Initial Population\":\n AgeInYearsAt(date from start of \"Measurement Period\") in Interval[18, 85]\n and \"Has Active Diabetes Overlaps Start Of Measurement Period\"\n and \"Has Outpatient Visit During Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 11 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Denominator" }, { "url" : "statement", "valueString" : "define \"Denominator\":\n \"Initial Population\"" }, { "url" : "displaySequence", "valueInteger" : 12 }], "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" : 13 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "SDE Payer" }, { "url" : "statement", "valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\"" }, { "url" : "displaySequence", "valueInteger" : 14 }], "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" : 15 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "SDE Ethnicity" }, { "url" : "statement", "valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\"" }, { "url" : "displaySequence", "valueInteger" : 16 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period\":\n exists ( ( [\"ConditionProblemsHealthConcerns\": \"Chronic Kidney Disease, Stage 5\"]\n union [\"ConditionEncounterDiagnosis\": \"Chronic Kidney Disease, Stage 5\"]\n )\n union ( [\"ConditionProblemsHealthConcerns\": \"End Stage Renal Disease\"]\n union [\"ConditionEncounterDiagnosis\": \"End Stage Renal Disease\"]\n ) ) CKDOrESRD\n where CKDOrESRD.onset.toInterval ( ) overlaps day of \"Measurement Period\"\n and ( CKDOrESRD.verificationStatus is not null implies ( CKDOrESRD.verificationStatus !~ Status.\"refuted\"\n and CKDOrESRD.verificationStatus !~ Status.\"entered-in-error\"\n )\n )" }, { "url" : "displaySequence", "valueInteger" : 17 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "Hospice" }, { "url" : "name", "valueString" : "Has Hospice Services" }, { "url" : "statement", "valueString" : "define \"Has Hospice Services\":\n exists ((([USQualityCore.Encounter: \"Encounter Inpatient\"]).isEncounterPerformed()) InpatientEncounter\n where (InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n or InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n )\n and InpatientEncounter.period ends during day of \"Measurement Period\"\n )\n or exists ((([USQualityCore.Encounter: \"Hospice Encounter\"]).isEncounterPerformed()) HospiceEncounter\n where HospiceEncounter.period overlaps day of \"Measurement Period\"\n )\n // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)\n or exists ((([USQualityCore.ObservationScreeningAssessment: code ~ \"Hospice care [Minimum Data Set]\"]).isAssessmentPerformed()) HospiceAssessment\n where HospiceAssessment.value ~ \"Yes (qualifier value)\"\n and HospiceAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([USQualityCore.ServiceRequest: \"Hospice Care Ambulatory\"]).isInterventionOrder()) HospiceOrder\n where HospiceOrder.authoredOn during day of \"Measurement Period\"\n )\n or exists ((([USQualityCore.Procedure: \"Hospice Care Ambulatory\"]).isInterventionPerformed()) HospicePerformed\n where HospicePerformed.performed.toInterval() overlaps day of \"Measurement Period\"\n )\n // TODO: Consider whether to keep this as the union of Problems and EncounterDiagnosis\n or exists ((([FHIR.Condition: \"Hospice Diagnosis\"]).verified()) HospiceCareDiagnosis\n where HospiceCareDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n )" }, { "url" : "displaySequence", "valueInteger" : 18 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "PalliativeCare" }, { "url" : "name", "valueString" : "Has Palliative Care in the Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Palliative Care in the Measurement Period\":\n // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)\n exists ((([USQualityCore.ObservationScreeningAssessment: code ~ \"Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)\"]).isAssessmentPerformed()) PalliativeAssessment\n where PalliativeAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n )\n // TODO: Consider whether to keep this as the union of the problems and encounter diagnosis list? Anything enforced by the profiles that is expected but isn't stated here?\n or exists ((([FHIR.Condition: \"Palliative Care Diagnosis\"]).verified()) PalliativeDiagnosis\n where PalliativeDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([USQualityCore.Encounter: \"Palliative Care Encounter\"]).isEncounterPerformed()) PalliativeEncounter\n where PalliativeEncounter.period overlaps day of \"Measurement Period\"\n )\n or exists ((([USQualityCore.Procedure: \"Palliative Care Intervention\"]).isInterventionPerformed()) PalliativeIntervention\n where PalliativeIntervention.performed.toInterval() overlaps day of \"Measurement Period\"\n )" }, { "url" : "displaySequence", "valueInteger" : 19 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "Denominator Exclusions" }, { "url" : "statement", "valueString" : "define \"Denominator Exclusions\":\n \"Has CKD Stage 5 Or ESRD Diagnosis Overlaps Measurement Period\"\n or Hospice.\"Has Hospice Services\"\n or PalliativeCare.\"Has Palliative Care in the Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 20 }], "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" : 21 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS951FHIRKidneyHealthEval" }, { "url" : "name", "valueString" : "SDE Race" }, { "url" : "statement", "valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\"" }, { "url" : "displaySequence", "valueInteger" : 22 }], "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" : 23 }], "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" : 24 }], "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" : 25 }], "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" : 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 uri): value.value" }, { "url" : "displaySequence", "valueInteger" : 27 }], "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):\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, 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, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n else\n null as Interval\n end" }, { "url" : "displaySequence", "valueInteger" : 28 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToDateTime" }, { "url" : "statement", "valueString" : "define function ToDateTime(value dateTime): value.value" }, { "url" : "displaySequence", "valueInteger" : 29 }], "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" : 30 }], "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" : 31 }], "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" : 32 }], "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" : 33 }], "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" : 34 }], "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" : 35 }], "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" : 36 }], "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" : 37 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value EncounterStatus): value.value" }, { "url" : "displaySequence", "valueInteger" : 38 }], "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" : 39 }], "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" : 40 }], "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" : 41 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "Status" }, { "url" : "name", "valueString" : "isEncounterPerformed" }, { "url" : "statement", "valueString" : "//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List):\n Enc E\n where E.status = 'finished'" }, { "url" : "displaySequence", "valueInteger" : 42 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "Status" }, { "url" : "name", "valueString" : "isAssessmentPerformed" }, { "url" : "statement", "valueString" : "//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List):\n Obs O\n where O.status in { 'final', 'amended', 'corrected' }" }, { "url" : "displaySequence", "valueInteger" : 43 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "Status" }, { "url" : "name", "valueString" : "isInterventionOrder" }, { "url" : "statement", "valueString" : "//Intervention, Order\ndefine fluent function isInterventionOrder(ServiceRequest List):\n ServiceRequest S\n where S.status in { 'active', 'completed' }\n and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}" }, { "url" : "displaySequence", "valueInteger" : 44 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value ServiceRequestStatus): value.value" }, { "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 ServiceRequestIntent): value.value" }, { "url" : "displaySequence", "valueInteger" : 46 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "Status" }, { "url" : "name", "valueString" : "isInterventionPerformed" }, { "url" : "statement", "valueString" : "//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List):\n Proc P\n where P.status ~ 'completed'" }, { "url" : "displaySequence", "valueInteger" : 47 }], "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" : 48 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "verified" }, { "url" : "statement", "valueString" : "/*\n@description: Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential\n*/\ndefine fluent function verified(conditions List):\n conditions C\n where C.verificationStatus is not null implies\n (C.verificationStatus ~ \"confirmed\"\n or C.verificationStatus ~ \"unconfirmed\"\n or C.verificationStatus ~ \"provisional\"\n or C.verificationStatus ~ \"differential\"\n )" }, { "url" : "displaySequence", "valueInteger" : 49 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "prevalenceInterval" }, { "url" : "statement", "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return \n\t if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]" }, { "url" : "displaySequence", "valueInteger" : 50 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "abatementInterval" }, { "url" : "statement", "valueString" : "/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n if condition.abatement is FHIR.dateTime then\n Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n else if condition.abatement is FHIR.Period then\n FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n else if condition.abatement is FHIR.string then\n Message(null as Interval, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n else if condition.abatement is FHIR.Age then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n else if condition.abatement is FHIR.Range then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n else if condition.abatement is FHIR.boolean then\n Interval[end of condition.onset.toInterval(), condition.recordedDate)\n else \n null" }, { "url" : "displaySequence", "valueInteger" : 51 }], "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" : 52 }], "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 Hospice", "resource" : "https://madie.cms.gov/Library/Hospice|7.1.000" }, { "type" : "depends-on", "display" : "Library PalliativeCare", "resource" : "https://madie.cms.gov/Library/PalliativeCare|2.1.000" }, { "type" : "depends-on", "display" : "Code system SNOMEDCT", "resource" : "http://snomed.info/sct" }, { "type" : "depends-on", "display" : "Code system ConditionVerificationStatusCodes", "resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status" }, { "type" : "depends-on", "display" : "Code system LOINC", "resource" : "http://loinc.org" }, { "type" : "depends-on", "display" : "Code system ConditionClinicalStatusCodes", "resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical" }, { "type" : "depends-on", "display" : "Value set Estimated Glomerular Filtration Rate", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1000" }, { "type" : "depends-on", "display" : "Value set Urine Albumin Creatinine Ratio", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1007" }, { "type" : "depends-on", "display" : "Value set Undetectable Lab Result Value", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.272" }, { "type" : "depends-on", "display" : "Value set Urine Albumin", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.88" }, { "type" : "depends-on", "display" : "Value set Urine Creatinine", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.87" }, { "type" : "depends-on", "display" : "Value set Diabetes", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001" }, { "type" : "depends-on", "display" : "Value set Annual Wellness Visit", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240" }, { "type" : "depends-on", "display" : "Value set Home Healthcare Services", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016" }, { "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 Outpatient Consultation", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services Established Office Visit, 18 and Up", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services Initial Office Visit, 18 and Up", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023" }, { "type" : "depends-on", "display" : "Value set Telephone Visits", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080" }, { "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 Chronic Kidney Disease, Stage 5", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002" }, { "type" : "depends-on", "display" : "Value set End Stage Renal Disease", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353" }, { "type" : "depends-on", "display" : "Value set Encounter Inpatient", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307" }, { "type" : "depends-on", "display" : "Value set Hospice Encounter", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003" }, { "type" : "depends-on", "display" : "Value set Hospice Care Ambulatory", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584" }, { "type" : "depends-on", "display" : "Value set Hospice Diagnosis", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165" }, { "type" : "depends-on", "display" : "Value set Palliative Care Diagnosis", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167" }, { "type" : "depends-on", "display" : "Value set Palliative Care Encounter", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090" }, { "type" : "depends-on", "display" : "Value set Palliative Care Intervention", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135" }], "parameter" : [{ "name" : "Measurement Period", "use" : "in", "min" : 0, "max" : "1", "type" : "Period" }, { "name" : "SDE Sex", "use" : "out", "min" : 0, "max" : "1", "type" : "Coding" }, { "name" : "Numerator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Denominator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "SDE Payer", "use" : "out", "min" : 0, "max" : "*", "type" : "Resource" }, { "name" : "Initial Population", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "SDE Ethnicity", "use" : "out", "min" : 0, "max" : "1", "type" : "Resource" }, { "name" : "Denominator Exclusions", "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" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"], "mustSupport" : ["code", "effective", "value", "status"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1000" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"], "mustSupport" : ["code", "effective", "status", "value"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.6929.3.1007" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"], "mustSupport" : ["code", "effective", "value", "status"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.88" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"], "mustSupport" : ["code", "effective", "value", "status"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.87" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080" }] }, { "type" : "Coverage", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage"], "mustSupport" : ["type", "period"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591" }] }, { "type" : "Condition", "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"], "mustSupport" : ["abatement", "verificationStatus", "onset", "recordedDate", "clinicalStatus"] }, { "type" : "Condition", "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"], "mustSupport" : ["code", "verificationStatus"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165" }] }, { "type" : "Condition", "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"], "mustSupport" : ["code", "verificationStatus"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167" }] }, { "type" : "Encounter", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"], "mustSupport" : ["type", "hospitalization", "hospitalization.dischargeDisposition", "period"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307" }] }, { "type" : "Encounter", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"], "mustSupport" : ["type", "period"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003" }] }, { "type" : "Encounter", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"], "mustSupport" : ["type", "period"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment"], "mustSupport" : ["code", "value", "effective", "status"], "codeFilter" : [{ "path" : "code", "code" : [{ "system" : "http://loinc.org", "code" : "45755-6", "display" : "Hospice care [Minimum Data Set]" }] }, { "path" : "value" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment"], "mustSupport" : ["code", "effective", "status"], "codeFilter" : [{ "path" : "code", "code" : [{ "system" : "http://loinc.org", "code" : "71007-9", "display" : "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)" }] }] }, { "type" : "ServiceRequest", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest"], "mustSupport" : ["code", "authoredOn"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584" }], "dateFilter" : [{ "path" : "authoredOn", "valuePeriod" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression", "valueExpression" : { "language" : "text/cql-identifier", "expression" : "Measurement Period" } }] } }] }, { "type" : "Procedure", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure"], "mustSupport" : ["code", "performed"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584" }] }, { "type" : "Procedure", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure"], "mustSupport" : ["code", "performed"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135" }] }] }], "extension" : [{ "id" : "supplementalDataGuidance", "extension" : [{ "url" : "guidance", "valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity and sex" }, { "url" : "usage", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data", "display" : "Supplemental Data" }], "text" : "Supplemental Data Guidance" } }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" }, { "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem", "valueReference" : { "reference" : "Device/cqf-tooling" } }, { "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements", "valueCanonical" : "#effective-data-requirements" }], "url" : "https://madie.cms.gov/Measure/CMS951FHIRKidneyHealthEval", "identifier" : [{ "use" : "usual", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "short-name", "display" : "Short Name" }] }, "system" : "https://madie.cms.gov/measure/shortName", "value" : "CMS951FHIR" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-independent", "display" : "Version Independent" }] }, "system" : "urn:ietf:rfc:3986", "value" : "urn:uuid:e66e345d-d892-4fe2-84a7-748433b6e0a6" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-specific", "display" : "Version Specific" }] }, "system" : "urn:ietf:rfc:3986", "value" : "urn:uuid:fc073788-dfa7-4163-a352-68d0fbdd99c8" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "publisher", "display" : "Publisher" }] }, "system" : "https://madie.cms.gov/measure/cmsId", "value" : "951FHIR", "assigner" : { "display" : "CMS" } }], "version" : "1.0.000", "name" : "CMS951FHIRKidneyHealthEval", "title" : "Kidney Health EvaluationFHIR\n", "status" : "active", "experimental" : false, "date" : "2026-01-16T18:18:14+00:00", "publisher" : "National Kidney Foundation", "contact" : [{ "telecom" : [{ "system" : "url", "value" : "www.kidney.org" }] }], "description" : "Percentage of patients aged 18-85 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period\n", "usage" : "This measure assesses the performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age).\n\nThe Urine Albumin-Creatinine Ratio (uACR) requirement can be met with a documented Urine Albumin and Urine Creatine conducted on the same urine sample AND reported less than or equal to four days apart. A calculation of uACR is not required to meet this measure, but it is intended to for the uACR to be calculated for the purposes of kidney health evaluation. If the Urine Albumin and Urine Creatine tests have different units of measure, they should be converted to the same unit of measure for the purposes of calculating uACR.\n\nThe Urine Albumin Creatinine Ratio Test requirement can be met if the lab result is received as a quantitative value or as an undetectable result. Undetectable results can be coded using values in the \"Undetectable Lab Result Value\" value set.\n\nThis dQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS951v4.\n\nPlease 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" : "Copyright 2025 National Kidney Foundation. All Rights Reserved.\n", "effectivePeriod" : { "start" : "2026-01-01", "end" : "2026-12-31" }, "author" : [{ "name" : "National Kidney Foundation", "telecom" : [{ "system" : "url", "value" : "www.kidney.org" }] }], "relatedArtifact" : [{ "type" : "citation", "citation" : "Alfego, D., Ennis, J., Gillespie, B., Lewis, M.J., Montgomery, E., Ferre, S., ... Letovsky, S. (2021). Chronic kidney disease testing among at-risk adults in the U.S. remains low: Real-world evidence from a National Laboratory database. Diabetes Care, 44(9), 2025-2032. https://doi.org/10.2337/dc21-0723\n" }, { "type" : "citation", "citation" : "American Diabetes Association Professional Practice Committee. (2023). Chronic kidney disease and risk management: Standards of medical care in diabetes-2023. Diabetes Care, 46(Supplement_1), S191-S202. https://doi.org/10.2337/dc23-S011\n" }, { "type" : "citation", "citation" : "Nichols, G.A, Ustyugova, A., Deruaz-Luyet, A., O'Keeffe-Rosetti, M., \\& Brodovicz, K.G. (2020). Health care costs by type of expenditure across eGFR stages among patients with and without diabetes, cardiovascular disease, and heart failure. JASN, 31(7), 1594-1601. https://doi.org/10.1681/asn.2019121308\n" }, { "type" : "citation", "citation" : "Saran R. B., Abbott K. C., ..., Zhang, X. (2019). US renal data system 2018 annual data report: Epidemiology of kidney disease in the United States. American Journal of Kidney Diseases, 73(3), Svii-Sxxii. https://doi.org/10.1053/j.ajkd.2019.01.001\n" }, { "type" : "citation", "citation" : "Stempneiwicz, N., Vassalotti, J.A., Cuddeback, J.K., Ciemins, E., Storfer-Isser, A., Sang, Y., ... Coresh, J. (2021). Chronic kidney disease testing among primary care patients with type 2 diabetes across 24 U.S. health care organizations. Diabetes Care, 44(9), 2000-2009. https://doi.org/10.2337/dc20-2715\n" }, { "type" : "citation", "citation" : "Szczech, L. A., Stewart, R. C., Su, H., Deloskey, R. J., Astor, B. C., Fox, C. H., ... Vassalotti, J. A. (2014). Primary care detection of chronic kidney disease in adults with type-2 diabetes: The ADD-CKD study (Awareness, detection and drug therapy in type 2 diabetes and chronic kidney disease). PLoS ONE, 9(11), e110535. https://doi.org/10.1371/journal.pone.0110535\n" }, { "type" : "citation", "citation" : "Bowe, B., Xie, Y., Li, T., Mokdad, A. H., Xian, H., Yan, Y.,... Al-Aly, Z. (2018). Changes in the US burden of chronic kidney disease from 2002 to 2016. JAMA Network Open, 1(7). doi: 10.1001/jamanetworkopen.2018.4412\n" }, { "type" : "citation", "citation" : "Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States. (2023). Retrieved from: https://www.cdc.gov/kidney-disease/php/data-research/?CDC_AAref_Val=https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html\n" }, { "type" : "citation", "citation" : "de Boer, I.H., Khunti, K., Sadusky, T., Tuttle, K.R., Neumiller, J.J., Rhee, Bakris, G. (2022). Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Kidney International, 102(5):974-989. doi: 10.1016/j.kint.2022.08.012\n" }, { "type" : "citation", "citation" : "Healthy People 2030. Retrieved from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/chronic-kidney-disease\n" }, { "type" : "citation", "citation" : "Hoerger, T. J., Simpson, S. A., Yarnoff, B. O., Pavkov, M. E., Burrows, N. R., Saydah, S. H., . . . Zhuo, X. (2015). The future burden of CKD in the United States: A simulation model for the CDC CKD Initiative. American Journal of Kidney Diseases, 65(3), 403-411. doi:10.1053/j.ajkd.2014.09.023\n" }, { "type" : "citation", "citation" : "Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S): S117--S314.\n" }, { "type" : "citation", "citation" : "National Kidney Foundation. (2007). KDOQI Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Retrieved from: https://www.kidney.org/sites/default/files/docs/diabetes_ajkd_febsuppl_07.pdf\n" }, { "type" : "citation", "citation" : "National Kidney Foundation. (2022). About chronic kidney disease. Retrieved from: https://www.kidney.org/atoz/content/about-chronic-kidney-disease\n" }], "library" : ["https://madie.cms.gov/Library/CMS951FHIRKidneyHealthEval"], "disclaimer" : "Physician Performance Measures (Measures) and related data specifications developed by the National Kidney Foundation (NKF) are intended to facilitate quality improvement activities by health care professionals.\n\nThese Measures are intended to assist health care professionals in enhancing quality of care. These Measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. NKF encourages testing and evaluation of its Measures.\n\nMeasures are subject to review and may be revised or rescinded at any time by NKF. The measures may not be altered without prior written approval from NKF. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed, or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and NKF. Neither NKF nor its members shall be responsible for any use of the measures.\n\nTHESE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited 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.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is 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 is copyright 2024 World Health Organization. All Rights Reserved.\n\nThe PCPI's and AMA's significant past efforts and contributions to the development and updating of the measure are acknowledged.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\].\n", "rationale" : "Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation \\[NKF\\], 2022), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes---the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018).\n\nThe intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual's lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes.\n", "clinicalRecommendationStatement" : "The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable:\n\nAt least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023)\n\nPatients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence:\n\n* 5 years after the diagnosis of type 1 diabetes; (A) or\n\n* From diagnosis of type 2 diabetes. (B)\n\n
\n\nScreening should include:\n\n* Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B)\n\n* Measurement of serum creatinine and estimation of GFR. (B)\n\n(NKF, 2007; NKF, 2012)\n", "group" : [{ "id" : "Group_1", "extension" : [{ "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "proportion", "display" : "Proportion" }] } }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis", "valueCode" : "boolean" }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-type", "code" : "process", "display" : "Process" }] } }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation", "valueString" : "None\n" }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "code" : "increase", "display" : "Increased score indicates improvement" }] } }], "population" : [{ "id" : "InitialPopulation_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population", "display" : "Initial Population" }] }, "description" : "All patients aged 18-85 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Initial Population" } }, { "id" : "Denominator_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator", "display" : "Denominator" }] }, "description" : "Equals Initial Population\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" : "Patients with a diagnosis of ESRD active during the measurement period; \n\nPatients with a diagnosis of CKD Stage 5 active during the measurement period; \n\nPatients who have an order for or are receiving hospice or palliative care.\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Denominator Exclusions" } }, { "id" : "Numerator_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator", "display" : "Numerator" }] }, "description" : "Patients who received a kidney health evaluation during the measurement period. Kidney health evaluation is defined by an eGFR AND uACR within the measurement period OR an eGFR and a Urine Albumin and Urine Creatine result documented less than or equal to four days apart\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Numerator" } }] }], "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" } }] }