PCSBMIScreenAndFollowUpFHIR
type: Measure
node role: treeRoot
id:
  v: PCSBMIScreenAndFollowUpFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm
    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Title: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up PlanFHIR Id: PCSBMIScreenAndFollowUpFHIR Download cql: PCSBMIScreenAndFollowUpFHIR.cql Version: 0.1.000 Url: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up PlanFHIR short-name identifier: CMS69FHIR version-independent identifier: urn:uuid:5d929142-0109-4dc3-97b5-27c9296b3cf9 version-specific identifier: urn:uuid:1039b9aa-b444-4112-ad53-1a86e16f9fcc publisher (CMS) identifier: 69FHIR Effective Period: 2024-01-01 ..2024-12-31 Status: draft Date: 2023-08-28 11:59:32+0000 Approval Date: 2023-08-28 Last Review Date: 2023-08-28 Name: PCSBMIScreenAndFollowUpFHIR Publisher: Centers for Medicare & Medicaid Services (CMS) Author: Mathematica: https://www.mathematica.org/ Description: Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if BMI was outside of normal parameters Use Context: code value program Purpose: UNKNOWN Copyright: Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved. Disclaimer: These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-category
        l: condition-category
      code:
        v: problem-list-item
      display:
        v: Problem List Item
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
        l: condition-category
      code:
        v: health-concern
      display:
        v: Health Concern
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: relapse
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-ActCode
        l: v3-ActCode
      code:
        v: VR
      display:
        v: virtual
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428361000124107
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428361000124107
      display:
        v: Discharge to home for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428371000124100
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428371000124100
      display:
        v: Discharge to healthcare facility for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/observation-category
        l: observation-category
      code:
        v: survey
      display:
        v: survey
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/45755-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 45755-6
      display:
        v: Hospice care [Minimum Data Set]
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: http://snomed.info/id/373066001
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 373066001
      display:
        v: Yes (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71007-9
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71007-9
      display:
        v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/39156-5
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 39156-5
      display:
        v: Body mass index (BMI) [Ratio]
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: SupplementalDataElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: SDE Sex
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "SDE Sex": case when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' } when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' } else null end
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 0

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Sex
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Sex": SDE."SDE Sex"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 1
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: BMI during Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "BMI during Measurement Period": ["observation-bmi"] BMI where BMI.value > 0 'kg/m2' and BMI.status in { 'final', 'amended', 'corrected' } and BMI.effective.toInterval ( ) during day of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Documented High BMI during Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Documented High BMI during Measurement Period": "BMI during Measurement Period" BMI where BMI.effective.toInterval ( ) during day of "Measurement Period" and BMI.value >= 25 'kg/m2'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: High BMI Interventions Ordered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "High BMI Interventions Ordered": ( ( [ServiceRequest: "Follow Up for Above Normal BMI"] union [ServiceRequest: "Referrals Where Weight Assessment May Occur"] union [MedicationRequest: "Medications for Above Normal BMI"] ) HighInterventionsOrdered where HighInterventionsOrdered.reasonCode in "Overweight or Obese" or ( exists [Condition: "Overweight or Obese"] OverweightObese where ( OverweightObese.isProblemListItem ( ) or OverweightObese.isHealthConcern ( ) ) and OverweightObese.isActive ( ) and OverweightObese.prevalenceInterval ( ) starts before or on day of HighInterventionsOrdered.authoredOn and not ( OverweightObese.prevalenceInterval ( ) ends before day of HighInterventionsOrdered.authoredOn ) ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: High BMI Interventions Performed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "High BMI Interventions Performed": ( [Procedure: "Follow Up for Above Normal BMI"] HighInterventionsPerformed where HighInterventionsPerformed.reasonCode in "Overweight or Obese" and HighInterventionsPerformed.status = 'completed' or ( exists [Condition: "Overweight or Obese"] OverweightObese where OverweightObese.isHealthConcern ( ) and OverweightObese.isActive ( ) and OverweightObese.prevalenceInterval ( ) starts before or on day of HighInterventionsPerformed.performed.toInterval ( ) and not ( OverweightObese.prevalenceInterval ( ) ends before day of HighInterventionsPerformed.performed.toInterval ( ) ) ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: High BMI and Follow up Provided
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "High BMI and Follow up Provided": "Documented High BMI during Measurement Period" HighBMI with ( "High BMI Interventions Ordered" union "High BMI Interventions Performed" ) HighBMIInterventions such that Coalesce(HighBMIInterventions.performed.toInterval(), HighBMIInterventions.authoredOn.toInterval()) starts during day of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Documented Low BMI during Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Documented Low BMI during Measurement Period": "BMI during Measurement Period" BMI where BMI.effective.toInterval ( ) during day of "Measurement Period" and BMI.value < 18.5 'kg/m2'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Low BMI Interventions Ordered
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Low BMI Interventions Ordered": ( ( [ServiceRequest: "Follow Up for Below Normal BMI"] union [ServiceRequest: "Referrals Where Weight Assessment May Occur"] union [MedicationRequest: "Medications for Below Normal BMI"] ) LowInterventionsOrdered where LowInterventionsOrdered.reasonCode in "Underweight" or ( exists [Condition: "Underweight"] Underweight where ( Underweight.isHealthConcern ( ) ) and Underweight.isActive ( ) and Underweight.prevalenceInterval ( ) starts before or on day of LowInterventionsOrdered.authoredOn and not ( Underweight.prevalenceInterval ( ) ends before day of LowInterventionsOrdered.authoredOn ) and LowInterventionsOrdered.authoredOn during day of "Measurement Period" ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Low BMI Interventions Performed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Low BMI Interventions Performed": ( [Procedure: "Follow Up for Below Normal BMI"] LowInterventionsPerformed where LowInterventionsPerformed.reasonCode in "Underweight" and LowInterventionsPerformed.status = 'completed' or ( exists [Condition: "Underweight"] Underweight where ( Underweight.isHealthConcern ( ) ) and Underweight.isActive ( ) and Underweight.prevalenceInterval ( ) starts before or on day of LowInterventionsPerformed.performed.toInterval ( ) and not ( Underweight.prevalenceInterval ( ) ends before day of LowInterventionsPerformed.performed.toInterval ( ) and LowInterventionsPerformed.performed.toInterval ( ) during day of "Measurement Period" ) ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Low BMI and Follow up Provided
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Low BMI and Follow up Provided": ( "Documented Low BMI during Measurement Period" LowBMI with ( "Low BMI Interventions Ordered" union "Low BMI Interventions Performed" ) LowBMIInterventions such that Coalesce(LowBMIInterventions.performed.toInterval(), LowBMIInterventions.authoredOn.toInterval()) starts during day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Normal BMI
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Normal BMI": exists ( "BMI during Measurement Period" BMI where BMI.value in Interval[18.5 'kg/m2', 24.9 'kg/m2'] ) and not ( exists "Documented High BMI during Measurement Period" or exists "Documented Low BMI during Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": exists "High BMI and Follow up Provided" or exists "Low BMI and Follow up Provided" or "Has Normal BMI"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Encounter during Day of Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Encounter during Day of Measurement Period": [Encounter: "Encounter to Evaluate BMI"] BMIEncounter where BMIEncounter.period during day of "Measurement Period" and BMIEncounter.class !~ "virtual" and BMIEncounter.status = 'finished'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": exists "Qualifying Encounter during Day of Measurement Period" QualifyingEncounter where "AgeInYearsAt"(date from start of QualifyingEncounter.period) >= 18
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": [Coverage: type in "Payer Type"] Payer return { code: Payer.type, period: Payer.period }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": SDE."SDE Payer"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": Patient.ethnicity E return Tuple { codes: { E.ombCategory } union E.detailed, display: E.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": SDE."SDE Ethnicity"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Hospice
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice Services
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice Services": exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.period.toInterval() ends during day of "Measurement Period" ) or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment where HospiceAssessment.value ~ "Yes (qualifier value)" and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period" ) or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period" ) or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PalliativeCare
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Palliative Care in the Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Palliative Care in the Measurement Period": exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Pregnancy
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Pregnancy": [Condition: "Pregnancy or Other Related Diagnoses"] PregnancyDiagnosis with "Qualifying Encounter during Day of Measurement Period" QualifyingEncounter such that PregnancyDiagnosis.clinicalStatus ~ QICoreCommon."active" and PregnancyDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": Hospice."Has Hospice Services" or PalliativeCare."Has Palliative Care in the Measurement Period" or exists "Pregnancy"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": Patient.race R return Tuple { codes: R.ombCategory union R.detailed, display: R.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": SDE."SDE Race"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Medical Reason for Not Documenting a Follow up Plan for Low or High BMI
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Medical Reason for Not Documenting a Follow up Plan for Low or High BMI": ( ( [ServiceNotRequested: "Referrals Where Weight Assessment May Occur"] union [ServiceNotRequested: "Follow Up for Above Normal BMI"] union [ServiceNotRequested: "Follow Up for Below Normal BMI"] ) NoBMIFollowUp with "Qualifying Encounter during Day of Measurement Period" QualifyingEncounter such that NoBMIFollowUp.authoredOn same day as start of QualifyingEncounter.period where NoBMIFollowUp.status ~ 'completed' and NoBMIFollowUp.reasonRefused in "Medical Reason" ) union ( ( [MedicationNotRequested: "Medications for Above Normal BMI"] union [MedicationNotRequested: "Medications for Below Normal BMI"] ) NoBMIFollowUp with "Qualifying Encounter during Day of Measurement Period" QualifyingEncounter such that NoBMIFollowUp.authoredOn same day as start of QualifyingEncounter.period where NoBMIFollowUp.status ~ 'completed' and NoBMIFollowUp.reasonCode in "Medical Reason" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Medical Reason or Patient Reason for Not Performing BMI Exam
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Medical Reason or Patient Reason for Not Performing BMI Exam": [ObservationNotDone: code = "Body mass index (BMI) [Ratio]"] NoBMI with "Qualifying Encounter during Day of Measurement Period" QualifyingEncounter such that NoBMI.effective.toInterval ( ) ends same day as start of QualifyingEncounter.period where NoBMI.status = 'cancelled' and ( NoBMI.notDoneReason in "Patient Declined" or NoBMI.notDoneReason in "Medical Reason" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PCSBMIScreenAndFollowUpFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exceptions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exceptions": exists "Medical Reason for Not Documenting a Follow up Plan for Low or High BMI" or exists "Medical Reason or Patient Reason for Not Performing BMI Exam"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: Library SDE
resource:
  v: Library/SupplementalDataElements|3.4.000
  l: http://ecqi.healthit.gov/ecqms/Library/SupplementalDataElements

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library QICoreCommon
resource:
  v: Library/QICoreCommon|1.5.000
  l: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library Hospice
resource:
  v: Library/Hospice|6.7.000
  l: http://ecqi.healthit.gov/ecqms/Library/Hospice

type:
  v: depends-on
display:
  v: Library Status
resource:
  v: Library/Status|1.6.000
  l: http://ecqi.healthit.gov/ecqms/Library/Status

type:
  v: depends-on
display:
  v: Library QICoreCommon
resource:
  v: Library/QICoreCommon|1.5.000
  l: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library PalliativeCare
resource:
  v: Library/PalliativeCare|1.7.000
  l: http://ecqi.healthit.gov/ecqms/Library/PalliativeCare

type:
  v: depends-on
display:
  v: Code system ConditionCategory
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-category
  l: condition-category

type:
  v: depends-on
display:
  v: Code system USCoreConditionCategoryExtensionCodes
resource:
  v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
  l: condition-category

type:
  v: depends-on
display:
  v: Code system ConditionClinicalStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-clinical
  l: condition-clinical

type:
  v: depends-on
display:
  v: Code system ActCode
resource:
  v: http://terminology.hl7.org/CodeSystem/v3-ActCode
  l: v3-ActCode

type:
  v: depends-on
display:
  v: Code system SNOMEDCT
resource:
  v: http://snomed.info/sct
  l: sct

type:
  v: depends-on
display:
  v: Code system ObservationCategoryCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/observation-category
  l: observation-category

type:
  v: depends-on
display:
  v: Code system LOINC
resource:
  v: http://loinc.org
  l: loinc.org

type:
  v: depends-on
display:
  v: Code system LOINC
resource:
  v: http://loinc.org
  l: loinc.org

type:
  v: depends-on
display:
  v: Value set Follow Up for Above Normal BMI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525

type:
  v: depends-on
display:
  v: Value set Referrals Where Weight Assessment May Occur
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527

type:
  v: depends-on
display:
  v: Value set Medications for Above Normal BMI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561

type:
  v: depends-on
display:
  v: Value set Overweight or Obese
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502

type:
  v: depends-on
display:
  v: Value set Follow Up for Below Normal BMI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528

type:
  v: depends-on
display:
  v: Value set Medications for Below Normal BMI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562

type:
  v: depends-on
display:
  v: Value set Underweight
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563

type:
  v: depends-on
display:
  v: Value set Encounter to Evaluate BMI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751

type:
  v: depends-on
display:
  v: Value set Payer Type
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: depends-on
display:
  v: Value set Encounter Inpatient
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
  v: depends-on
display:
  v: Value set Hospice Encounter
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003

type:
  v: depends-on
display:
  v: Value set Hospice Care Ambulatory
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: depends-on
display:
  v: Value set Hospice Diagnosis
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165

type:
  v: depends-on
display:
  v: Value set Palliative Care Diagnosis
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: depends-on
display:
  v: Value set Palliative Care Encounter
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: depends-on
display:
  v: Value set Palliative Care Intervention
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: depends-on
display:
  v: Value set Pregnancy or Other Related Diagnoses
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1623
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1623

type:
  v: depends-on
display:
  v: Value set Medical Reason
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007

type:
  v: depends-on
display:
  v: Value set Patient Declined
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582

name:
  v: Measurement Period
use:
  v: in
min:
  v: 0
max:
  v: 1
type:
  v: Period

name:
  v: SDE Sex
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Coding

name:
  v: Numerator
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: Denominator
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Payer
use:
  v: out
min:
  v: 0
max:
  v: *
type:
  v: Resource

name:
  v: Initial Population
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Ethnicity
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Resource

name:
  v: Denominator Exclusions
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Race
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Resource

name:
  v: Denominator Exceptions
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/Patient
  l: Patient
must support:
  v: gender
must support:
  v: gender.value
must support:
  v: birthDate
must support:
  v: birthDate.value

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/Condition
  l: Condition
must support:
  v: clinicalStatus

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
  l: qicore-medicationrequest
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
  l: qicore-medicationrequest
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: reasonCode
must support:
  v: status
must support:
  v: status.value
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.502

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
  l: qicore-medicationrequest
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
  l: qicore-medicationrequest
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: reasonCode
must support:
  v: status
must support:
  v: status.value
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1563

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/bmi
  l: bmi
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: class
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: class
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751

type:
  v: Coverage
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
  l: qicore-coverage
must support:
  v: type
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: uri
profile:
  v: http://hl7.org/fhir/uri
  l: uri
must support:
  v: value

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: hospitalization
must support:
  v: hospitalization.dischargeDisposition
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/45755-6
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 45755-6
    display:
      v: Hospice care [Minimum Data Set]

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: effective
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/45755-6
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 45755-6
    display:
      v: Hospice care [Minimum Data Set]

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
must support:
  v: authoredOn
must support:
  v: authoredOn.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/71007-9
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 71007-9
    display:
      v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/71007-9
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 71007-9
    display:
      v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
must support:
  v: clinicalStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1623
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1623

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: class
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1527

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1525

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
  l: qicore-servicenotrequested
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1528

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: class
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1751

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested
  l: qicore-mednotrequested
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested
  l: qicore-mednotrequested
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1561

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested
  l: qicore-mednotrequested
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested
  l: qicore-mednotrequested
must support:
  v: medication
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1562

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
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v: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up PlanFHIR

v: draft

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v: 2023-08-28T11:59:32+00:00

v: Centers for Medicare & Medicaid Services (CMS)

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v: Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if BMI was outside of normal parameters

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v: UNKNOWN

v: BMI Measurement Guidance: - Height and Weight - An eligible professional or their staff is required to measure both height and weight. Both height and weight must be measured during the measurement period. Self-reported values cannot be used. - The BMI may be documented in the medical record of the provider or in outside medical records obtained by the provider. - If the documented BMI is outside of normal parameters, then a follow-up plan is documented during the encounter or during the measurement period. - If more than one BMI is reported during the measurement period, and any of the documented BMI assessments is outside of normal parameters, documentation of an appropriate follow-up plan will be used to determine if performance has been met. - Review the exclusions and exceptions criteria to determine those patients that BMI measurement may not be appropriate or necessary. Follow-Up Plan Guidance: The documented follow-up plan must be based on the documented BMI, outside of normal parameters, example: "Patient referred to nutrition counseling for BMI above or below normal parameters." See the Definition section for examples of follow-up plan treatments. Variation has been noted in studies exploring optimal BMI ranges for the elderly (see Donini et al., 2012; Holme & Tonstad, 2015; Diehr et al., 2008). Notably however, all these studies have arrived at ranges that differ from the standard range for ages 18 and older, which is >= 18.5 and < 25 kg/m2. For instance, both Donini et al. and Holme and Tonstad reported findings that suggest that higher BMI (higher than the upper end of 25 kg/m2) in the elderly may be beneficial. Similarly, worse outcomes have been associated with being underweight (at a threshold higher than 18.5 kg/m2) at age 65 (Diehr et al., 2008). Because of optimal BMI range variation recommendations from these studies, no specific optimal BMI range for the elderly is used. However, it may be appropriate to exempt certain patients from a follow-up …

v: 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. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved.

v: 2023-08-28

v: 2023-08-28

start:
  v: 2024-01-01
end:
  v: 2024-12-31

name:
  v: Mathematica
telecom:
  system:
    v: url
  value:
    v: https://www.mathematica.org/

v: These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

v: BMI Above Normal Parameters “Obesity is a chronic, multifactorial disease with complex psychological, environmental (social and cultural), genetic, physiologic, metabolic and behavioral causes and consequences. The prevalence of overweight and obese people is increasing worldwide at an alarming rate in both developing and developed countries. Environmental and behavioral changes brought about by economic development, modernization and urbanization have been linked to the rise in global obesity. The health consequences are becoming apparent” (Fitch et al., 2013). More than a third of U.S. adults have a body mass index [BMI] >= 30 kg/m2 and are at increased risk for diabetes, cardiovascular disease (CVD), and obstructive sleep apnea (Flegal et al., 2012; Ogden et al., 2015; Dong et al., 2020). Hales et al. (2017), reported that the prevalence of obesity among adults and youth in the United States was 39.8 percent and 18.5 percent respectively, from 2015-2016. Furthermore, the prevalence of obesity in adults increased to 42.4 percent in 2018, with the highest percentage among adults in the 40-59 age bracket compared with other age groups (Hales et al., 2020). Hales et al. (2020) also disaggregated the data according to race/ethnicity and noted that obesity prevalence was higher among non-Hispanic Black adults and Hispanic adults when compared with other races and ethnicities. Obesity prevalence was lowest among non-Hispanic Asian men and women. Among men, obesity prevalence was higher among Hispanic men compared with non-Hispanic Black men and non-Hispanic White men. Among women, the prevalence among non-Hispanic Black women was 56.9 percent, which was higher than all other race/ethnicities. In general, the prevalence of obesity in the U.S. remains higher than the Healthy People 2020 goals of 30.5 percent among adults (Hales et al., 2020). BMI continues to be a common and reasonably reliable measurement to identify overweight and obese adults who may be at an increased…

v: All adults should be screened annually using a BMI measurement. BMI measurements >= 25 kg/m2 should be used to initiate further evaluation of overweight or obesity after taking into account age, gender, ethnicity, fluid status, and muscularity; therefore, clinical evaluation and judgment must be used when BMI is employed as the anthropometric indicator of excess adiposity, particularly in athletes and those with sarcopenia (Garvey et al., 2016) (Grade A). Overweight and Underweight Categories: Underweight < 18.5; Normal weight 18.5-24.9; Overweight 25-29.9; Obese class I 30-34.9; Obese class II 35-39.9; Obese class III >= 40 (Garvey et al., 2016). BMI cutoff point value of >= 23 kg/m2 should be used in the screening and confirmation of excess adiposity in Asian adults (Garvey et al., 2016) (Grade B). Lifestyle/behavioral therapy for overweight and obesity should include behavioral interventions that enhance adherence to prescriptions for a reduced-calorie meal plan and increased physical activity (behavioral interventions can include: self-monitoring of weight, food intake, and physical activity; clear and reasonable goal-setting; education pertaining to obesity, nutrition, and physical activity; face-to-face and group meetings; stimulus control; systematic approaches for problem solving; stress reduction; cognitive restructuring [i.e., cognitive behavioral therapy], motivational interviewing; behavioral contracting; psychological counseling; and mobilization of social support structures) (Garvey et al., 2016) (Grade A). Behavioral lifestyle intervention should be tailored to a patient's ethnic, cultural, socioeconomic, and educational background (Garvey et al., 2016) (Grade B). The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians offer or refer adults with a BMI of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions (USPSTF, 2018) (Grade B). Interventions: - Effective intensive behavioral interventions were designed to he…

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