Data Exchange Profiles for 2022 CDC Clinical Practice Guideline for Prescribing Opioids, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cdc-opioid-cpg/ and changes regularly. See the Directory of published versions

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Official URL: http://hl7.org/fhir/us/cdc-opioid-cpg/ImplementationGuide/hl7.fhir.us.cdc-opioid-cpg				Version: 1.0.0	Highlight text changes?
IG Standards status: Trial-use Active as of 2024-11-27				Maturity Level: 3	Computable Name: CDCOpioidCPG

Summary

Defines exchange expectations for systems that implement the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain, both in terms of the data required to evaluate whether recommendations are applicable, as well as the data required to represent proposals resulting from those recommendations.

Note that the title of this implementation guide intentionally includes the version year of the CDC Clinical Practice Guideline for Prescribing Opioids to ensure that users understand exactly which version of the guidance is being supported.

Scope of Use

This implementation guide defines FHIR profiles that characterize the data elements used in the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain recommendations. The decision support logic authoring and clinical relevance of the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is not within the scope of this implementation guide.

How to read this Guide

1. Home & Background – Introduces the opioid crisis context and relationship to the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain.

2. Profiles - A listing of profiles used in each recommendation and subroutine.

3. Artifacts – Detailed definitions of every profile, extension, value set, and operation.

4. Change History & Roadmap – Links to ballot comments and future work items.

Target Audiences

1. EHR and HIT vendors looking to supply opioid-related data in a consistent, reusable format.

2. Clinical decision support developers looking to retrieve complete patient context to execute the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain logic distributed in the 2022 CDC Clinical Practice Guideline for Prescribing Opioids IG.

Acknowledgements

This Implementation Guide was made possible by the thoughtful contributions of the following people and organizations:

• Centers for Disease Control and Prevention (CDC) – clinical subject-matter expertise and reference content for the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain.

• The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP) - identify and develop standards for clinical decision support.

• HL7 Clinical Decision Support Work Group – project sponsorship and ballot reconciliation.

• Clinical Quality Framework (CQF) Initiative – source content and reference implementations from the 2022 CDC Clinical Practice Guideline for Prescribing Opioids IG.

Credits

Project Team

• Johnathan Coleman (Security Risk Solutions)
• Mohammad Jafari, PhD (Security Risk Solutions)
• Kensaku Kawamoto, MD, PhD, MHS (Independent)
• Robert McClure, MD (Independent)
• Amber Patel (Security Risk Solutions)
• Bryn Rhodes (Smile CDR)
• Chris Schuler (Smile CDR)
• Greg White (Security Risk Solutions)

Government Leadership

• Mera Choi (ASTP)
• Alison Kemp, MPH (ASTP)
• Anastasia Perchem (ASTP)
• Adam Wong, MPP (ASTP)

Dependencies

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.us.cdc-opioid-cpg.r4) and R4B (hl7.fhir.us.cdc-opioid-cpg.r4b) are available.

Global Profiles

Global Profiles:

Type	Source	Profile
Encounter	hl7.fhir.us.qicore#6.0.0	QICore Encounter
Immunization	hl7.fhir.us.qicore#6.0.0	QICore Immunization
Observation	hl7.fhir.us.qicore#6.0.0	QICore Simple Observation
Organization	hl7.fhir.us.qicore#6.0.0	QICore Organization
Patient	hl7.fhir.us.qicore#6.0.0	QICore Patient
Practitioner	hl7.fhir.us.qicore#6.0.0	QICore Practitioner
PractitionerRole	hl7.fhir.us.qicore#6.0.0	QICore PractitionerRole

All resources of these types must conform to these profiles.

IP Statements

This publication includes IP covered under the following statements.

• ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
  Show Usage
  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: ActiveCancerEncounterDiagnosisCondition, ActiveCancerProblemListHealthConcernCondition... Show 55 more, AcutePainManagementMedicationRequest, AmphetamineMedication, AmphetamineMedicationRequest, AmphetamineUrineDrugScreeningResultObservation, BarbiturateMedication, BarbiturateMedicationRequest, BarbiturateUrineDrugScreeningResultObservation, BenzodiazepineMedication, BenzodiazepineMedicationRequest, BenzodiazepineUrineDrugScreeningResultObservation, BuprenorphineMedication, BuprenorphineMedicationRequest, BuprenorphineUrineDrugScreeningResultObservation, CDCOpioidCPG, CNSDepressantMedication, CNSDepressantMedicationRequest, CannabinoidUrineDrugScreeningResultObservation, ChronicPainManagementMedicationRequest, CocaineUrineDrugScreeningResultObservation, EndOfLifeEncounterDiagnosis, EndOfLifeProblemsListHealthConcernCondition, ExtendedReleaseOpioidMedication, ExtendedReleaseOpioidMedicationRequest, FentanylMedication, FentanylMedicationRequest, FentanylUrineDrugScreeningResultObservation, HeroinUrineDrugScreeningResultObservation, MMEMedicationRequest, MethadoneMedication, MethadoneMedicationRequest, MethadoneUrineDrugScreeningResultObservation, NaloxoneMedication, NaloxoneMedicationRequest, OpiateMedication, OpiateMedicationRequest, OpiateUrineDrugScreeningResultObservation, OpioidMedication, OpioidMedicationRequest, OpioidMisuseAssessmentProcedure, OpioidReviewIndicatedPatient, OpioidReviewIndicatedPatientEncounter, OpioidReviewIndicatedPatientMedicationRequest, OxycodoneMedication, OxycodoneMedicationRequest, OxycodoneUrineDrugScreeningResultObservation, PCPUrineDrugScreeningResultObservation, PDMPReviewObservation, PDMPReviewProcedure, PainManagementProcedure, PainTreatmentCarePlan, SickleCellEncounterDiagnosisCondition, SickleCellProblemListHealthConcernCondition, SubacuteOrChronicPainManagementMedicationRequest, SubacutePainManagementMedicationRequest and UrineDrugScreeningResultObservation
• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  • LOINC: AmphetamineUrineDrugScreeningResultObservation, BarbiturateUrineDrugScreeningResultObservation... Show 24 more, BenzodiazepineUrineDrugScreeningResultObservation, BuprenorphineUrineDrugScreeningResultObservation, CannabinoidUrineDrugScreeningResultObservation, CarePlan/pain-treatment, CocaineUrineDrugScreeningResultObservation, FentanylUrineDrugScreeningResultObservation, HeroinUrineDrugScreeningResultObservation, MethadoneUrineDrugScreeningResultObservation, Observation/amphetamine-urine-drug-screening-result, Observation/barbiturate-urine-drug-screening-result, Observation/benzodiazepine-urine-drug-screening-result, Observation/buprenorphine-urine-drug-screening-result, Observation/cannabinoid-urine-drug-screening-result, Observation/cocaine-urine-drug-screening-result, Observation/fentanyl-urine-drug-screening-result, Observation/heroin-urine-drug-screening-result, Observation/methadone-urine-drug-screening-result, Observation/opiate-urine-drug-screening-result, Observation/oxycodone-urine-drug-screening-result, Observation/pcp-urine-drug-screening-result, OpiateUrineDrugScreeningResultObservation, OxycodoneUrineDrugScreeningResultObservation, PCPUrineDrugScreeningResultObservation and PainTreatmentCarePlan
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  • SNOMED Clinical Terms® (SNOMED CT®): Condition/end-of-life-diagnosis, Condition/end-of-life-problem-list... Show 14 more, Condition/sickle-cell-encounter-diagnosis, Condition/sickle-cell-problem-list, EndOfLifeEncounterDiagnosis, EndOfLifeProblemsListHealthConcernCondition, Observation/pdmp-review, OpioidMisuseAssessmentProcedure, PDMPReviewObservation, PDMPReviewProcedure, PainManagementProcedure, Procedure/opioid-misuse-assessment, Procedure/pain-management, Procedure/pdmp-review, SickleCellEncounterDiagnosisCondition and SickleCellProblemListHealthConcernCondition
• This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  • Condition Category Codes: ActiveCancerEncounterDiagnosisCondition, Condition/active-cancer-diagnosis... Show 4 more, Condition/end-of-life-diagnosis, Condition/sickle-cell-encounter-diagnosis, EndOfLifeEncounterDiagnosis and SickleCellEncounterDiagnosisCondition
  • Condition Clinical Status Codes: Condition/active-cancer-diagnosis, Condition/active-cancer-problem-list... Show 4 more, Condition/end-of-life-diagnosis, Condition/end-of-life-problem-list, Condition/sickle-cell-encounter-diagnosis and Condition/sickle-cell-problem-list
  • ConditionVerificationStatus: Condition/active-cancer-diagnosis, Condition/active-cancer-problem-list... Show 4 more, Condition/end-of-life-diagnosis, Condition/end-of-life-problem-list, Condition/sickle-cell-encounter-diagnosis and Condition/sickle-cell-problem-list
  • MedicationRequest Course of Therapy Codes: AcutePainManagementMedicationRequest, ChronicPainManagementMedicationRequest... Show 18 more, ExtendedReleaseOpioidMedicationRequest, MedicationRequest/acute-pain-management, MedicationRequest/amphetamine, MedicationRequest/barbiturate, MedicationRequest/benzodiazepine, MedicationRequest/buprenorphine, MedicationRequest/chronic-pain-management, MedicationRequest/cns-depressant, MedicationRequest/extended-release-opioid, MedicationRequest/fentanyl, MedicationRequest/methadone, MedicationRequest/mme, MedicationRequest/naloxone, MedicationRequest/opiate, MedicationRequest/opioid, MedicationRequest/opioid-review-indicated-patient, MedicationRequest/oxycodone and SubacuteOrChronicPainManagementMedicationRequest
  • Observation Category Codes: AmphetamineUrineDrugScreeningResultObservation, BarbiturateUrineDrugScreeningResultObservation... Show 24 more, BenzodiazepineUrineDrugScreeningResultObservation, BuprenorphineUrineDrugScreeningResultObservation, CannabinoidUrineDrugScreeningResultObservation, CocaineUrineDrugScreeningResultObservation, FentanylUrineDrugScreeningResultObservation, HeroinUrineDrugScreeningResultObservation, MethadoneUrineDrugScreeningResultObservation, Observation/amphetamine-urine-drug-screening-result, Observation/barbiturate-urine-drug-screening-result, Observation/benzodiazepine-urine-drug-screening-result, Observation/buprenorphine-urine-drug-screening-result, Observation/cannabinoid-urine-drug-screening-result, Observation/cocaine-urine-drug-screening-result, Observation/fentanyl-urine-drug-screening-result, Observation/heroin-urine-drug-screening-result, Observation/methadone-urine-drug-screening-result, Observation/opiate-urine-drug-screening-result, Observation/oxycodone-urine-drug-screening-result, Observation/pcp-urine-drug-screening-result, Observation/pdmp-review, OpiateUrineDrugScreeningResultObservation, OxycodoneUrineDrugScreeningResultObservation, PCPUrineDrugScreeningResultObservation and UrineDrugScreeningResultObservation
  • identifierType: Patient/opioid-review-indicated
  • ActCode: Encounter/opioid-review-indicated-patient
  • Orderable Drug Form: MedicationRequest/amphetamine, MedicationRequest/barbiturate... Show 11 more, MedicationRequest/benzodiazepine, MedicationRequest/buprenorphine, MedicationRequest/cns-depressant, MedicationRequest/fentanyl, MedicationRequest/methadone, MedicationRequest/mme, MedicationRequest/naloxone, MedicationRequest/opiate, MedicationRequest/opioid, MedicationRequest/opioid-review-indicated-patient and MedicationRequest/oxycodone
• Used by permission of HL7 International, all rights reserved Creative Commons License
  Show Usage
  • US Core CarePlan Category Extension Codes: CarePlan/pain-treatment and PainTreatmentCarePlan
  • US Core Condition Category Extension Codes: Condition/active-cancer-problem-list, Condition/end-of-life-problem-list and Condition/sickle-cell-problem-list
• Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
  Show Usage
  • RxNorm: AmphetamineMedication, AmphetamineMedicationRequest... Show 38 more, BarbiturateMedication, BarbiturateMedicationRequest, BenzodiazepineMedication, BenzodiazepineMedicationRequest, BuprenorphineMedication, BuprenorphineMedicationRequest, CNSDepressantMedication, CNSDepressantMedicationRequest, ExtendedReleaseOpioidMedication, ExtendedReleaseOpioidMedicationRequest, FentanylMedication, FentanylMedicationRequest, Medication/amphetamine, Medication/barbiturate, Medication/benzodiazepine, Medication/buprenorphine, Medication/cns-depressant, Medication/extended-release-opioid, Medication/fentanyl, Medication/methadone, Medication/naloxone, Medication/opiate, Medication/opioid, Medication/oxycodone, MedicationRequest/acute-pain-management, MedicationRequest/chronic-pain-management, MedicationRequest/mme, MedicationRequest/subacute-pain-management, MethadoneMedication, MethadoneMedicationRequest, NaloxoneMedication, NaloxoneMedicationRequest, OpiateMedication, OpiateMedicationRequest, OpioidMedication, OpioidMedicationRequest, OxycodoneMedication and OxycodoneMedicationRequest

Expansion Parameters

Parameter	Value
system-version	SNOMED CT[US]
system-version	International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)[2021]
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ActiveCancerEncounterDiagnosisCondition|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ActiveCancerProblemListHealthConcernCondition|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/AcutePainManagementMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/AmphetamineMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/AmphetamineMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/AmphetamineUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BarbiturateMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BarbiturateMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BarbiturateUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BenzodiazepineMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BenzodiazepineMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BenzodiazepineUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BuprenorphineMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BuprenorphineMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/BuprenorphineUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/CannabinoidUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/CNSDepressantMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/CNSDepressantMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ChronicPainManagementMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/CocaineUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/EndOfLifeEncounterDiagnosis|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/EndOfLifeProblemsListHealthConcernCondition|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ExtendedReleaseOpioidMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ExtendedReleaseOpioidMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/FentanylMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/FentanylMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/FentanylUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/HeroinUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/MethadoneMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/MethadoneMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/MethadoneUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/MMEMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/NaloxoneMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/NaloxoneMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpiateMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpiateMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpiateUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidMisuseAssessmentProcedure|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidReviewIndicatedPatientEncounter|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidReviewIndicatedPatient|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OpioidReviewIndicatedPatientMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OxycodoneMedication|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OxycodoneMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/OxycodoneUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/PainManagementProcedure|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/PainTreatmentCarePlan|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/PDMPReviewObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/PDMPReviewProcedure|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/PCPUrineDrugScreeningResultObservation|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/SickleCellEncounterDiagnosisCondition|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/SickleCellProblemListHealthConcernCondition|1.0.0
default-canonical-version	http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/SubacutePainManagementMedicationRequest|1.0.0
default-canonical-version	http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0