Library - dQM QICore Content Implementation Guide v2025.0.0

dQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-qicore-2025/ and changes regularly. See the Directory of published versions

Narrative Content

Library: Library

Official URL: https://madie.cms.gov/Measure/CMS1218FHIRHHRF#effective-data-requirements				Version: 1.0.000
Active			Responsible: Centers for Medicare & Medicaid Services (CMS)	Computable Name: EffectiveDataRequirements

Metadata

Type http://terminology.hl7.org/CodeSystem/library-type#module-definition

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period, priority
Code Filter(s):
Path: type
ValueSet: Elective Inpatient Encounter

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate.value

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Outpatient Surgery Service

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value, performed
Code Filter(s):
Path: code
ValueSet: General and Neuraxial Anesthesia Excluding Local, Regional, and Axillary

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period, priority, reasonCode
Code Filter(s):
Path: type
ValueSet: Elective Inpatient Encounter

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Observation Services

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Emergency Department Visit

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
Code(s): LOINC: 9279-1 (Respiratory rate)

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate
Must Support Elements: value

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: partOf

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, status, status.value
Code Filter(s):
Path: code
ValueSet: Albumin lab test

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-temperature
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
Code(s): LOINC: 8310-5 (Body temperature)

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-temperature
Must Support Elements: value

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
Code(s): LOINC: 8867-4 (Heart rate)

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: value

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
Must Support Elements: status, status.value, effective, value

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
Must Support Elements: value

Data Requirement Type: Resource
Profile(s): Resource
Must Support Elements: id

Data Requirement Type: Resource
Profile(s): Resource
Must Support Elements: id.value

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: effective

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, status, status.value, value
Code Filter(s):
Path: code
Code(s): LOINC: 97816-3 (American society of anesthesiologists morbidity state)

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
Must Support Elements: effective, value, status, status.value

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure
Must Support Elements: effective

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure
Must Support Elements: effective, status, status.value, component

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: extension

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: General and Neuraxial Anesthesia Excluding Local, Regional, and Axillary

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: General and Neuraxial Anesthesia Excluding Local, Regional, and Axillary

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Anesthesia Requiring Monitored Care

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value, performed, id, id.value
Code Filter(s):
Path: code
ValueSet: Intubation

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value
Code Filter(s):
Path: code
ValueSet: Non Invasive Oxygen Therapy by Nasal Cannula or Mask

Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: period

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: effective

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value, performed
Code Filter(s):
Path: code
Code(s): SNOMED CT: 271280005 (Removal of endotracheal tube (procedure))

Data Requirement Type: Location
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location
Must Support Elements: type

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value, performed, id, id.value
Code Filter(s):
Path: code
Code(s): SNOMED CT: 271280005 (Removal of endotracheal tube (procedure))

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: status, status.value, id, id.value, code, performed

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value
Code Filter(s):
Path: code
ValueSet: Head, Neck, and Thoracic Surgeries with High Risk Airway Compromise

Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: performed

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
ValueSet: Carbon Dioxide Partial Pressure in Arterial Blood

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
ValueSet: Arterial Blood pH

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, status, status.value, effective, value
Code Filter(s):
Path: code
ValueSet: Oxygen Partial Pressure in Arterial Blood

Data Requirement Type: Claim
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim
Must Support Elements: status, status.value, use, use.value, item

Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis

Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns

Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: value

Data Requirement Type: Coverage
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type

Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url, extension

Parameters

Name	Use	Card.	Type	Documentation
Measurement Period	In	0..1	Period
Risk Variable First Respiratory Rate In Encounter	Out	0..*	Resource
Risk Variable First Albumin In Encounter	Out	0..*	Resource
Risk Variable First Arterial pH In Encounter	Out	0..*	Resource
Risk Variable First Body Temperature In Encounter	Out	0..*	Resource
Risk Variable First Carbon Dioxide In Encounter	Out	0..*	Resource
Risk Variable First Hematocrit In Encounter	Out	0..*	Resource
Risk Variable First Heart Rate In Encounter	Out	0..*	Resource
Risk Variable First BMI	Out	0..*	Resource
Risk Variable First Hemoglobin In Encounter	Out	0..*	Resource
Risk Variable All Encounter Diagnoses With POA Indication	Out	0..*	Resource
Risk Variable First Sodium In Encounter	Out	0..*	Resource
SDE Payer	Out	0..*	Resource
Initial Population	Out	0..*	Resource
Risk Variable First Creatinine In Encounter	Out	0..*	Resource
Risk Variable First White Blood Cell Count In Encounter	Out	0..*	Resource
Risk Variable ASA Physical Status Class	Out	0..*	CodeableConcept
Risk Variable Principal Procedure	Out	0..*	Resource
Risk Variable Body Mass Index (BMI)	Out	0..*	Quantity
Risk Variable First Bicarbonate In Encounter	Out	0..*	Resource
Risk Variable First Bilirubin In Encounter	Out	0..*	Resource
Risk Variable First Systolic Blood Pressure In Encounter	Out	0..*	Resource
Risk Variable First Oxygen In Encounter	Out	0..*	Resource
Risk Variable First Leukocyte Count In Encounter	Out	0..*	Resource
SDE Race	Out	0..1	Resource
SDE Sex	Out	0..1	Coding
Numerator	Out	0..*	Resource
Denominator	Out	0..*	Resource
Risk Variable Encounter Procedures	Out	0..*	Resource
Risk Variable First Blood Urea Nitrogen In Encounter	Out	0..*	Resource
SDE Ethnicity	Out	0..1	Resource
Denominator Exclusions	Out	0..*	Resource
Risk Variable First AST In Encounter	Out	0..*	Resource
Risk Variable First Platelet Count In Encounter	Out	0..*	Resource

Citations and References

Dependency Description: Library FHIRHelpers
Resource: FHIRHelpers version: 4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000

Dependency Description: Library QICoreCommon
Resource: QICoreCommon version: 4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000

Dependency Description: Library CQMCommon
Resource: CQMCommon version: 4.1.000
Canonical URL: https://madie.cms.gov/Library/CQMCommon|4.1.000

Dependency Description: Library FHIRHelpers
Resource: FHIRHelpers version: 4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000

Dependency Description: Library SDE
Resource: SupplementalDataElements version: 5.1.000
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000

Dependency Description: Library FHIRHelpers
Resource: FHIRHelpers version: 4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000

Dependency Description: Library QICoreCommon
Resource: QICoreCommon version: 4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000

Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct

Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org

Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct

Dependency Description: Code system LocationRoles
Resource: RoleCode
Canonical URL: http://terminology.hl7.org/CodeSystem/v3-RoleCode

Dependency Description: Code system Diagnosis Type
Resource: Example Diagnosis Type Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/ex-diagnosistype

Dependency Description: Value set Elective Inpatient Encounter
Resource: Elective Inpatient Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.85

Dependency Description: Value set Emergency Department Visit
Resource: Emergency Department Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292

Dependency Description: Value set Obstetrical Or Pregnancy Related Conditions
Resource: Obstetrical or Pregnancy Related Conditions
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263

Dependency Description: Value set General And Neuraxial Anesthesia
Resource: General and Neuraxial Anesthesia Excluding Local, Regional, and Axillary
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.208

Dependency Description: Value set Observation Services
Resource: Observation Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143

Dependency Description: Value set Emergency Department Visit
Resource: Emergency Department Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292

Dependency Description: Value set Outpatient Surgery Service
Resource: Outpatient Surgery Service
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.38

Dependency Description: Value set Albumin Lab Test
Resource: Albumin lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.221

Dependency Description: Value set Arterial Blood pH
Resource: Arterial Blood pH
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.96

Dependency Description: Value set Carbon Dioxide Partial Pressure In Arterial Blood
Resource: Carbon Dioxide Partial Pressure in Arterial Blood
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.95

Dependency Description: Value set Hematocrit Lab Test
Resource: Hematocrit Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114

Dependency Description: Value set Hemoglobin Lab Test
Resource: Hemoglobin lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.219

Dependency Description: Value set Sodium Lab Test
Resource: Sodium Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.119

Dependency Description: Value set Payer Type
Resource: Payer Type
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

Dependency Description: Value set Creatinine Lab Test
Resource: Creatinine Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.2363

Dependency Description: Value set White Blood Cells Count Lab Test
Resource: White Blood Cells Count Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129

Dependency Description: Value set ASA Physical Status Class
Resource: ASA physical status class
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.217

Dependency Description: Value set Bicarbonate Lab Test
Resource: Bicarbonate Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.139

Dependency Description: Value set Bilirubin Lab Test
Resource: Bilirubin lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.223

Dependency Description: Value set Oxygen Partial Pressure In Arterial Blood
Resource: Oxygen Partial Pressure in Arterial Blood
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.94

Dependency Description: Value set Leukocyte Count Lab Test
Resource: Leukocyte count lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.222

Dependency Description: Value set Intubation
Resource: Intubation
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.179

Dependency Description: Value set Anesthesia Requiring Monitored Care
Resource: Anesthesia Requiring Monitored Care
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.255

Dependency Description: Value set Mechanical Ventilation
Resource: Mechanical Ventilation
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.107

Dependency Description: Value set Non Invasive Oxygen Therapy By Nasal Cannula Or Mask
Resource: Non Invasive Oxygen Therapy by Nasal Cannula or Mask
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.209

Dependency Description: Value set Non Invasive Oxygen Therapy
Resource: Non Invasive Oxygen Therapy
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.213

Dependency Description: Value set Blood Urea Nitrogen Lab Test
Resource: Blood urea nitrogen lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.218

Dependency Description: Value set Degenerative Neurological Disorder
Resource: Degenerative Neurological Disorder
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.241

Dependency Description: Value set Head, Neck, And Thoracic Surgeries With High Risk Airway Compromise
Resource: Head, Neck, and Thoracic Surgeries with High Risk Airway Compromise
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.251

Dependency Description: Value set Neuromuscular Disorder
Resource: Neuromuscular Disorder
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.239

Dependency Description: Value set Acute Respiratory Failure
Resource: Acute Respiratory Failure
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.88

Dependency Description: Value set Present On Admission Or Clinically Undetermined
Resource: Present on Admission or Clinically Undetermined
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.197

Dependency Description: Value set Tracheostomy Diagnoses
Resource: Tracheostomy Diagnoses
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.89

Dependency Description: Value set Tracheostomy Procedures
Resource: Tracheostomy Procedures
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.181

Dependency Description: Value set Aspartate transaminase Lab Test
Resource: Aspartate transaminase lab test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.224

Dependency Description: Value set Platelet Count Lab Test
Resource: Platelet Count Lab Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.127

Generated using version 0.5.6 of the sample-content-ig Liquid templates