StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
type: Measure
node role: treeRoot
id:
  v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
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text:
  status:
    v: extensions
  div:
    v: Title: Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR Id: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR Download cql: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR.cql Version: 0.1.000 Url: Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR short-name identifier: CMS347FHIR version-independent identifier: urn:uuid:4d3066c5-88f7-48d2-8a93-9f946e1a41a6 version-specific identifier: urn:uuid:fd954048-8292-417e-bc77-aa0d99fb8540 publisher (CMS) identifier: 347FHIR Effective Period: 2024-01-01 ..2024-12-31 Status: draft Date: 2023-08-27 20:52:19+0000 Approval Date: 2023-08-28 Last Review Date: 2023-08-28 Name: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR Publisher: Centers for Medicare & Medicaid Services (CMS) Author: Mathematica: https://www.mathematica.org/ Description: Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR Patients aged 20 - 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR Patients aged 40 - 75 years with a diagnosis of diabetes; OR Patients aged 40 - 75 with a 10-year ASCVD risk score of >= 20 percent 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 I…
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      code:
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      display:
        v: Cardiovascular disease 10Y risk [Likelihood]
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    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: ASVCD Diagnosis or Procedure before End of Measurement Period

url:
  v: statement
  l: statement
value: String
  v: define "ASVCD Diagnosis or Procedure before End of Measurement Period": ( ( [Condition: "Myocardial Infarction"] union [Condition: "Cerebrovascular Disease Stroke or TIA"] union [Condition: "Atherosclerosis and Peripheral Arterial Disease"] union [Condition: "Ischemic Heart Disease or Other Related Diagnoses"] union [Condition: "Stable and Unstable Angina"] ) ASCVDDiagnosis where ( ASCVDDiagnosis.isProblemListItem ( ) or ASCVDDiagnosis.isHealthConcern ( ) ) and ASCVDDiagnosis.prevalenceInterval ( ) starts on or before day of end of "Measurement Period" and ASCVDDiagnosis.isActive ( ) ) union ( ( [Procedure: "PCI"] union [Procedure: "CABG Surgeries"] union [Procedure: "Carotid Intervention"] union [Procedure: "CABG or PCI Procedure"] ) ASCVDProcedure where ASCVDProcedure.performed.toInterval ( ) starts on or before day of end of "Measurement Period" and ASCVDProcedure.status = 'completed' )

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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: "Annual Wellness Visit"] union [Encounter: "Office Visit"] union [Encounter: "Outpatient Consultation"] union [Encounter: "Outpatient Encounters for Preventive Care"] union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"] union [Encounter: "Preventive Care Services Individual Counseling"] union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"] union [Encounter: "Preventive Care Services Other"] /*union [Encounter: "UnlistedEncounter"This will change with a future standards update CQLIT-368*/ ) QualifyingEncounter where QualifyingEncounter.period during day of "Measurement Period" and QualifyingEncounter.status = 'finished'
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    v: libraryName
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    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population 1
extension:
  url:
    v: statement
    l: statement
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    v: define "Initial Population 1": exists "ASVCD Diagnosis or Procedure before End of Measurement Period" and exists "Qualifying Encounter during day of Measurement Period"
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  url:
    v: libraryName
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  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Patients Aged 20 to 75 at Start of Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patients Aged 20 to 75 at Start of Measurement Period": AgeInYearsAt(date from start of "Measurement Period") in Interval[20, 75]
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  url:
    v: libraryName
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  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: LDL Result Greater Than or Equal To 190
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "LDL Result Greater Than or Equal To 190": [Observation: "LDL Cholesterol"] LDL190 where LDL190.value as Quantity >= 190 'mg/dL' and LDL190.effective.toInterval ( ) starts before end of "Measurement Period" and LDL190.status in { 'final', 'amended', 'corrected', 'appended' }
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    v: 4
url:
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extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Hypercholesterolemia Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Hypercholesterolemia Diagnosis": ( [Condition: "Familial Hypercholesterolemia"] Hypercholesterolemia where ( Hypercholesterolemia.isProblemListItem ( ) or Hypercholesterolemia.isHealthConcern ( ) ) and Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of "Measurement Period" and Hypercholesterolemia.isActive ( ) )
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extension:
  url:
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    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD": "Patients Aged 20 to 75 at Start of Measurement Period" and exists ( "LDL Result Greater Than or Equal To 190" union "Hypercholesterolemia Diagnosis" ) and not exists ( "ASVCD Diagnosis or Procedure before End of Measurement Period" )
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    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population 2
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population 2": "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD" and exists "Qualifying Encounter during day of Measurement Period"
extension:
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    v: libraryName
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    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 }
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    v: 8
url:
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extension:
  url:
    v: libraryName
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  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
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:
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    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
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extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Diabetes Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Diabetes Diagnosis": exists ( [Condition: "Diabetes"] Diabetes where ( Diabetes.isProblemListItem ( ) or Diabetes.isHealthConcern ( ) ) and Diabetes.prevalenceInterval ( ) overlaps day of "Measurement Period" and Diabetes.isActive ( ) )
extension:
  url:
    v: displaySequence
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    v: 10
url:
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extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia": AgeInYearsAt(date from start of "Measurement Period") >= 40 and AgeInYearsAt(date from start of "Measurement Period") <= 75 and "Has Diabetes Diagnosis" and ( not exists "ASVCD Diagnosis or Procedure before End of Measurement Period" and not exists "LDL Result Greater Than or Equal To 190" and not exists "Hypercholesterolemia Diagnosis" )
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    v: 11
url:
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extension:
  url:
    v: libraryName
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  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population 3
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population 3": "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia" and exists "Qualifying Encounter during day of Measurement Period"
extension:
  url:
    v: displaySequence
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    v: 12
url:
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extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Ten Year CVD Risk is High
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Ten Year CVD Risk is High": ( exists ( [Observation: "Cardiovascular disease 10Y risk [Likelihood]"] union [Observation: "Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"] ) AtRiskCVD where AtRiskCVD.value as Quantity >= 20 '%' and AtRiskCVD.effective.toInterval ( ) during day of "Measurement Period" )
extension:
  url:
    v: displaySequence
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  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: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes": AgeInYearsAt(date from start of "Measurement Period") in Interval[40, 75] and "Ten Year CVD Risk is High" and not ( exists "ASVCD Diagnosis or Procedure before End of Measurement Period" or exists "Hypercholesterolemia Diagnosis" or exists "LDL Result Greater Than or Equal To 190" or "Has Diabetes Diagnosis" )
extension:
  url:
    v: displaySequence
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    v: 14
url:
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extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population 4
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population 4": "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes" and exists "Qualifying Encounter during day of Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
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  l: cqfm-logicDefinition

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: 16
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
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: 17
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator 3
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator 3": "Initial Population 3"
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: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Statin Therapy Prescribed Anytime during day of Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Statin Therapy Prescribed Anytime during day of Measurement Period": ( [MedicationRequest: "Low Intensity Statin Therapy"] union [MedicationRequest: "Moderate Intensity Statin Therapy"] union [MedicationRequest: "High Intensity Statin Therapy"] ) StatinPrescribed where StatinPrescribed.status in { 'active', 'completed' } and StatinPrescribed.intent ~ 'order' and StatinPrescribed.doNotPerform is not true and ( StatinPrescribed.authoredOn during day of "Measurement Period" or exists ( StatinPrescribed.dosageInstruction.timing T where T.repeat.bounds.toInterval ( ) overlaps day of "Measurement Period" ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
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  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": exists "Statin Therapy Prescribed Anytime during 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: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator 2
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator 2": "Initial Population 2"
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: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator 4
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator 4": "Initial Population 4"
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: 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: 23
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
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: 24
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: 25
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
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: 26
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": exists ( ( [Condition: "Breastfeeding"] union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis where ( ExclusionDiagnosis.isProblemListItem ( ) or ExclusionDiagnosis.isHealthConcern ( ) ) and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period" and ExclusionDiagnosis.isActive ( ) )
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: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator 1
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator 1": "Initial Population 1"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Allergy to Statin
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Allergy to Statin": exists ( [AllergyIntolerance: "Statin Allergen"] StatinAllergy where QICoreCommon."ToInterval" ( StatinAllergy.onset ) overlaps day of "Measurement Period" and StatinAllergy.clinicalStatus ~ QICoreCommon."allergy-active" or StatinAllergy.clinicalStatus is null )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
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: 30
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: 31
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hepatitis or Liver Disease Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hepatitis or Liver Disease Diagnosis": exists ( ( [Condition: "Hepatitis A"] union [Condition: "Hepatitis B"] union [Condition: "Liver Disease"] ) HepatitisLiverDisease where ( HepatitisLiverDisease.isProblemListItem ( ) or HepatitisLiverDisease.isHealthConcern ( ) ) and HepatitisLiverDisease.prevalenceInterval ( ) overlaps day of "Measurement Period" and HepatitisLiverDisease.isActive ( ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Statin Associated Muscle Symptoms
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Statin Associated Muscle Symptoms": exists ( [Condition: "Statin Associated Muscle Symptoms"] StatinMuscleSymptom where ( StatinMuscleSymptom.isProblemListItem ( ) or StatinMuscleSymptom.isHealthConcern ( ) ) and StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of "Measurement Period" and StatinMuscleSymptom.isActive ( ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has ESRD Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has ESRD Diagnosis": exists ( [Condition: "End Stage Renal Disease"] ESRD where ( ESRD.isProblemListItem ( ) or ESRD.isHealthConcern ( ) ) and ESRD.prevalenceInterval ( ) overlaps day of "Measurement Period" and ESRD.isActive ( ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Adverse Reaction to Statin
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Adverse Reaction to Statin": exists ( [AdverseEvent: event in "Statin Allergen"] StatinReaction where StatinReaction.recordedDate during day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Medical Reason for Not Ordering Statin Therapy
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Medical Reason for Not Ordering Statin Therapy": exists ( ( [MedicationNotRequested: "Low Intensity Statin Therapy"] union [MedicationNotRequested: "Moderate Intensity Statin Therapy"] union [MedicationNotRequested: "High Intensity Statin Therapy"] ) NoStatinTherapyOrdered with "Qualifying Encounter during day of Measurement Period" QualifyingEncounter such that NoStatinTherapyOrdered.authoredOn during QualifyingEncounter.period and NoStatinTherapyOrdered.status = 'completed' and NoStatinTherapyOrdered.reasonCode in "Medical Reason" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exceptions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exceptions": "Has Allergy to Statin" or Hospice."Has Hospice Services" or PalliativeCare."Has Palliative Care in the Measurement Period" or "Has Hepatitis or Liver Disease Diagnosis" or "Has Statin Associated Muscle Symptoms" or "Has ESRD Diagnosis" or "Has Adverse Reaction to Statin" or "Has Medical Reason for Not Ordering Statin Therapy"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
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 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 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 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 LOINC
resource:
  v: http://loinc.org
  l: loinc.org

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

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: Value set Myocardial Infarction
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.403
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.403

type:
  v: depends-on
display:
  v: Value set Cerebrovascular Disease Stroke or TIA
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44

type:
  v: depends-on
display:
  v: Value set Atherosclerosis and Peripheral Arterial Disease
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21

type:
  v: depends-on
display:
  v: Value set Ischemic Heart Disease or Other Related Diagnoses
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46

type:
  v: depends-on
display:
  v: Value set Stable and Unstable Angina
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47

type:
  v: depends-on
display:
  v: Value set PCI
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67

type:
  v: depends-on
display:
  v: Value set CABG Surgeries
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694

type:
  v: depends-on
display:
  v: Value set Carotid Intervention
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204

type:
  v: depends-on
display:
  v: Value set CABG or PCI Procedure
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566

type:
  v: depends-on
display:
  v: Value set Annual Wellness Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240

type:
  v: depends-on
display:
  v: Value set Office Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001

type:
  v: depends-on
display:
  v: Value set Outpatient Consultation
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008

type:
  v: depends-on
display:
  v: Value set Outpatient Encounters for Preventive Care
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576

type:
  v: depends-on
display:
  v: Value set Preventive Care Services Established Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025

type:
  v: depends-on
display:
  v: Value set Preventive Care Services Individual Counseling
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026

type:
  v: depends-on
display:
  v: Value set Preventive Care Services Initial Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023

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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574

type:
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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/2.16.840.1.113883.3.526.3.1574
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574

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/2.16.840.1.113883.3.526.3.1575
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575

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/2.16.840.1.113883.3.526.3.1575
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575

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/2.16.840.1.113883.3.526.3.1572
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572

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/2.16.840.1.113883.3.526.3.1572
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572

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: 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: 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/2.16.840.1.113762.1.4.1047.73
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73

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/2.16.840.1.113762.1.4.1047.102
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102

type:
  v: AllergyIntolerance
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
  l: qicore-allergyintolerance
must support:
  v: code
must support:
  v: onset
must support:
  v: clinicalStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42

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
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024

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/2.16.840.1.113883.3.67.1.101.1.269
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.269

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/2.16.840.1.113762.1.4.1047.42
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42

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/2.16.840.1.113762.1.4.1108.85
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85

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/2.16.840.1.113883.3.526.3.353
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353

type:
  v: AdverseEvent
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent
  l: qicore-adverseevent
must support:
  v: event
must support:
  v: recordedDate
must support:
  v: recordedDate.value
code filter:
  path:
    v: event
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42

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/2.16.840.1.113883.3.526.3.1574
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574

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/2.16.840.1.113883.3.526.3.1574
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574

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/2.16.840.1.113883.3.526.3.1575
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575

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/2.16.840.1.113883.3.526.3.1575
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575

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/2.16.840.1.113883.3.526.3.1572
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572

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/2.16.840.1.113883.3.526.3.1572
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572

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

id:
  v: supplementalDataGuidance
extension:
  url:
    v: guidance
    l: guidance
extension:
  url:
    v: usage
    l: usage
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-data-usage
        l: measure-data-usage
      code:
        v: supplemental-data
      display:
        v: Supplemental Data
    text:
      v: Supplemental Data Guidance
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
  l: cqfm-supplementalDataGuidance

url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements
  l: cqfm-effectiveDataRequirements
value: Reference
  l: effective-data-requirements
  reference:
    v: #effective-data-requirements

use:
  v: usual
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: short-name
system:
  v: https://madie.cms.gov/measure/shortName
  l: shortName
value:
  v: CMS347FHIR

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: version-independent
system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: version-specific
system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
  coding:
    system:
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v: 0.1.000

v: StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR

v: Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR

v: draft

v: false

v: 2023-08-27T20:52:19+00:00

v: Centers for Medicare & Medicaid Services (CMS)

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v: Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR - Patients aged 20 - 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR - Patients aged 40 - 75 years with a diagnosis of diabetes; OR - Patients aged 40 - 75 with a 10-year ASCVD risk score of >= 20 percent

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value: CodeableConcept
  coding:
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v: UNKNOWN

v: Initial Population Guidance: The initial population covers four distinct populations. Use the following process to prevent counting patients more than once. Initial Population 1: All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period. - If YES, meets Initial Population 1 risk category - If NO, screen for next risk category Initial Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. - If YES, meets Initial Population 2 risk category - If NO, screen for next risk category Initial Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. - If YES, meets Initial Population 3 risk category - If NO, screen for next risk category Initial Population 4: Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of >= 20 percent during the measurement period. - If YES, meets Initial Population 4 risk category - If NO, patient does NOT meet Initial Population criteria and is NOT eligible for measure inclusion. Initial Population Guidance for Encounter: In order for the patient to be included in the Initial Population, the patient must have ONE initial population-eligible visit, defined as follows: outpatient visit, initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit. LDL-C Laboratory test result options: The measure can be reported for all patients with a documented LDL-C level recorded as follows: To meet Initial Population 1: There is no LDL-C result required. To meet Initial Population 2: If a patient has ANY previous laboratory result of LD…

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: "Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 3 deaths in the United States in 2015. In 2015, stroke caused approximately 1 of every 19 deaths in the United States and the estimated annual costs for CVD and stroke were $329.7 billion, including $199.2 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $130.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group" (Benjamin et al., 2018). Data collected between 2011 and 2014 indicates that more than 94.6 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 28.5 million had levels 240 mg/dL or more (Benjamin et al., 2018). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015). In 2018, updated guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (Grundy et al., 2019). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The American College of Cardiology (ACC)/American Heart Association (AHA)/Multi-society (MS) Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of ASCVD in patients of all ages. The document concludes that the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: in…

v: This electronic clinical quality measure is intended to align with the 2018 ACC/AHA/MS Guideline on the Management of Blood Cholesterol (Grundy et al., 2019), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations. Recommendations for Management of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment: Secondary Prevention: 1. In patients who are 75 years of age or younger with clinical ASCVD, high-intensity statin therapy should be initiated or continued with the aim of achieving a 50% or greater reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019). 2. In patients with clinical ASCVD in whom high-intensity statin therapy is contraindicated or who experience statin-associated side effects, moderate-intensity statin therapy should be initiated or continued with the aim of achieving a 30% to 49% reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019). 3. In patients older than 75 years of age with clinical ASCVD, it is reasonable to initiate moderate- or high-intensity statin therapy after evaluation of the potential for ASCVD risk reduction, adverse effects, and drug–drug interactions, as well as patient frailty and patient preferences (Class IIa Recommendation), (Grundy et al., 2019). Primary Prevention 1. In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL or higher (>= 4.9 mmol/L), maximally tolerated statin therapy is recommended. (Class I Recommendation), (Grundy et al., 2019). 2. In adults 40 to 75 years of age with diabetes mellitus, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated (Class I Recommendation), (Grundy et al., 2019). 3. To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific Pooled Cohort Equations (PCE) to estimate 10-year …

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