Quality Measure Implementation Guide
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Quality Measure Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Measure: EXM130 - Colorectal Cancer Screening Measure (Experimental)

Official URL: http://hl7.org/fhir/uv/cqfmeasures/Measure/EXM130-FHIR Version: 8.0.000
Active as of 2022-02-22 Computable Name: EXM130
Other Identifiers: http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms#130 (use: official, ), http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf#0034 (use: official, )

Usage:Venue: EC

Copyright/Legal: This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

This measure has been developed to support improvement in clinical care.

Knowledge Artifact Metadata
Name (machine-readable) EXM130
Title (human-readable) EXM130 - Colorectal Cancer Screening Measure
Status Active
Experimental true
Description

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

Purpose

This measure has been developed to support improvement in clinical care.

Approval Date 2016-01-01
Effective Period 2018-01-01..2018-12-31
Use Context Venue = EC
Topic Health Quality Measure Document
Measure Steward HL7 International / Clinical Quality Information
Steward Contact Details http://www.hl7.org/Special/committees/cqi
Copyright

This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.

Measure Metadata
Version Number 8.0.000
Measure Scoring Proportion
Measure Type Process
Rationale

Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017).

Clinical Recommendation Statement

The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)

Improvement Notation Increased score indicates improvement
Guidance

Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE.

Measure Population Criteria
Initial Population Description: No description provided Logic Definition: Initial Population
Numerator Description: No description provided Logic Definition: Numerator
Denominator Description: No description provided Logic Definition: Denominator
Denominator Exclusion Description: No description provided Logic Definition: Denominator Exclusion
Supplemental Data Elements
Supplemental Data Element Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Ethnicity
Supplemental Data Element Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Payer
Supplemental Data Element Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Race
Supplemental Data Element Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Sex
Measure Logic
Primary Library EXM130 - Colorectal Cancer Screening Library
Dependency Description: Library SDE
Resource: Supplemental Data Elements Libraryversion: null2.0.0)
Canonical URL: http://hl7.org/fhir/uv/cqfmeasures/Library/SupplementalDataElements|2.0.000
Dependency Description: Library FHIRHelpers
Resource: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Dependency Description: Library Global
Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000
Dependency Description: Library AdultOutpatientEncounters
Resource: Adult Outpatient Encounters Common Libraryversion: null2.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000
Dependency Description: Library Hospice
Resource: Hospice FHIR Libraryversion: null2.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqfmeasures/Library/Hospice|2.0.000
Dependency Description: Code system SNOMEDCT:2017-09
Resource: http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709
Canonical URL: http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709
Dependency Description: Value set Colonoscopy
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
Dependency Description: Value set Fecal Occult Blood Test (FOBT)
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
Dependency Description: Value set Flexible Sigmoidoscopy
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
Dependency Description: Value set FIT DNA
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
Dependency Description: Value set CT Colonography
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
Dependency Description: Value set Payer
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Dependency Description: Value set Office Visit
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Dependency Description: Value set Annual Wellness Visit
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Dependency Description: Value set Preventive Care Services - Established Office Visit, 18 and Up
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Dependency Description: Value set Preventive Care Services-Initial Office Visit, 18 and Up
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Dependency Description: Value set Home Healthcare Services
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Dependency Description: Value set Encounter Inpatient
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Dependency Description: Value set Hospice care ambulatory
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Dependency Description: Value set Malignant Neoplasm of Colon
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
Dependency Description: Value set Total Colectomy
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
Direct Reference Code Display: Discharge to home for hospice care (procedure)
Code: 428361000124107
System: http://snomed.info/sct
Direct Reference Code Display: Discharge to healthcare facility for hospice care (procedure)
Code: 428371000124100
System: http://snomed.info/sct
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: SDE Sex
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Payer
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Ethnicity
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Coding
Parameter Name: Denominator Exclusion
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Race
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Coding
Measure Logic Data Requirements
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: period, type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: extension, value, url
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period, hospitalization, hospitalization.dischargeDisposition, type, status
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, onset
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: effective, code, value, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: effective, code, value, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: code, performed, status
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: code, authoredOn, intent
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Measure Logic Definitions
Logic Definition Library Name: SupplementalDataElements
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
Logic Definition Library Name: EXM130-FHIR
define "SDE Sex":
  SDE."SDE Sex"
Logic Definition Library Name: EXM130-FHIR
define "Colonoscopy Performed":
	[Procedure: "Colonoscopy"] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global."Normalize Interval"(Colonoscopy.performed) ends 10 years or less on or before end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Fecal Occult Blood Test Performed":
	[Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global."Normalize Interval"(FecalOccultResult.effective) during day of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Flexible Sigmoidoscopy Performed":
	[Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global."Normalize Interval"(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Fecal Immunochemical Test DNA":
	[Observation: "FIT DNA"] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global."Normalize Interval"(FitDNA.effective) occurs 3 years or less on or before day of end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "CT Colonography Performed":
	[Procedure: "CT Colonography"] Colonography
		where Colonography.status = 'completed'
			and Global."Normalize Interval"(Colonography.performed) ends 5 years or less on or before end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Numerator":
	exists "Colonoscopy Performed"
		or exists "Fecal Occult Blood Test Performed"
		or exists "Flexible Sigmoidoscopy Performed"
		or exists "Fecal Immunochemical Test DNA"
		or exists "CT Colonography Performed"
Logic Definition Library Name: EXM130-FHIR
define "Denominator":
	true
Logic Definition Library Name: SupplementalDataElements
define "SDE Payer":
  [Coverage: type in "Payer"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
Logic Definition Library Name: EXM130-FHIR
define "SDE Payer":
  SDE."SDE Payer"
Logic Definition Library Name: AdultOutpatientEncounters
define "Qualifying Encounters":
	(
    [Encounter: "Office Visit"]
  		union [Encounter: "Annual Wellness Visit"]
  		union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
  		union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
  		union [Encounter: "Home Healthcare Services"]
  ) ValidEncounter
		where ValidEncounter.period during "Measurement Period"
  		and ValidEncounter.status  = 'finished'
Logic Definition Library Name: EXM130-FHIR
define "Initial Population":
	Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75]
			and exists AdultOutpatientEncounters."Qualifying Encounters"
Logic Definition Library Name: SupplementalDataElements
define "SDE Ethnicity":
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding
Logic Definition Library Name: EXM130-FHIR
define "SDE Ethnicity":
  SDE."SDE Ethnicity"
Logic Definition Library Name: Hospice
define "Has Hospice":
	exists (
    [Encounter: "Encounter Inpatient"] DischargeHospice
			where DischargeHospice.status = 'finished'
		    and (
	        DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
				    or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
	    	)
				and DischargeHospice.period ends during "Measurement Period"
	)
    or exists (
      [ServiceRequest: "Hospice care ambulatory"] HospiceOrder
        where HospiceOrder.intent = 'order'
            and HospiceOrder.authoredOn in "Measurement Period"
    )
    or exists (
      [Procedure: "Hospice care ambulatory"] HospicePerformed
        where HospicePerformed.status = 'completed'
          and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
    )
Logic Definition Library Name: EXM130-FHIR
define "Malignant Neoplasm Ever":
	[Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
		where Global."Normalize Interval"(ColorectalCancer.onset) starts on or before end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Total Colectomy Performed":
	[Procedure: "Total Colectomy"] Colectomy
		where Colectomy.status = 'completed'
			and Global."Normalize Interval"(Colectomy.performed) starts on or before end of "Measurement Period"
Logic Definition Library Name: EXM130-FHIR
define "Denominator Exclusion":
	Hospice."Has Hospice"
		or exists "Malignant Neoplasm Ever"
		or exists "Total Colectomy Performed"
Logic Definition Library Name: SupplementalDataElements
define "SDE Race":
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding
Logic Definition Library Name: EXM130-FHIR
define "SDE Race":
  SDE."SDE Race"
Generated using version 0.4.6 of the sample-content-ig Liquid templates