Quality Measure Implementation Guide
1.0.0-ballot - ballot International flag

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

: EXM130 - Colorectal Cancer Screening Measure - XML Representation

Active as of 2022-02-22

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<Measure xmlns="http://hl7.org/fhir">
  <id value="EXM130-FHIR"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/uv/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/uv/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <table class="narrative-table">
    <tbody>
<tr>

<th colspan="2" scope="row" class="row-header">Knowledge Artifact Metadata</th>

</tr>

<tr>

<th scope="row" class="row-header">Name (machine-readable)</th>

<td class="content-container">EXM130</td>
</tr>


<tr>

<th scope="row" class="row-header">Title (human-readable)</th>

<td class="content-container">EXM130 - Colorectal Cancer Screening Measure</td>
</tr>



<tr>

<th scope="row" class="row-header">Status</th>

<td class="content-container">Active</td>
</tr>


<tr>

<th scope="row" class="row-header">Experimental</th>

<td class="content-container">true</td>
</tr>


<tr>

<th scope="row" class="row-header">Description</th>

<td class="content-container"><div><p>Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer</p>
</div></td>
</tr>


<tr>

<th scope="row" class="row-header">Purpose</th>

<td class="content-container"><div><p>This measure has been developed to support improvement in clinical care.</p>
</div></td>
</tr>



<tr>

<th scope="row" class="row-header">Approval Date</th>

<td class="content-container">2016-01-01</td>
</tr>




<tr>

<th scope="row" class="row-header">Effective Period</th>

<td class="content-container">2018-01-01..2018-12-31</td>
</tr>



<tr>

<th scope="row" class="row-header">Use Context</th>

<td class="content-container"><span title="{http://terminology.hl7.org/CodeSystem/usage-context-type venue}">Venue</span> = <span title="Codes:{http://hl7.org/fhir/uv/cqfmeasures/CodeSystem/intended-venue-codes ec}">EC</span></td>
</tr>


<tr>

<th scope="row" class="row-header">Topic</th>

<td class="content-container"><span title="Codes:{http://loinc.org 57024-2}">Health Quality Measure Document</span></td>
</tr>






<tr>

<th scope="row" class="row-header">Measure Steward</th>

<td class="content-container">HL7 International / Clinical Quality Information</td>
</tr>


<tr>

<th scope="row" class="row-header">Steward Contact Details</th>

<td class="content-container"><a href="http://www.hl7.org/Special/committees/cqi">http://www.hl7.org/Special/committees/cqi</a></td>
</tr>


<tr>

<th scope="row" class="row-header">Copyright</th>

<td class="content-container"><div><p>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.</p>
</div></td>
</tr>










<tr>

<th colspan="2" scope="row" class="row-header">Measure Metadata</th>

</tr>






<tr>

<th scope="row" class="row-header">Version Number</th>

<td class="content-container">8.0.000</td>
</tr>


<tr>

<th scope="row" class="row-header">Measure Scoring</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}">Proportion</span></td>
</tr>



<tr>

<th scope="row" class="row-header">Measure Type</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-type process}">Process</span></td>
</tr>




<tr>

<th scope="row" class="row-header">Rationale</th>

<td class="content-container"><div><p>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).</p>
</div></td>
</tr>


<tr>

<th scope="row" class="row-header">Clinical Recommendation Statement</th>

<td class="content-container"><div><p>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)</p>
</div></td>
</tr>


<tr>

<th scope="row" class="row-header">Improvement Notation</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}">Increased score indicates improvement</span></td>
</tr>



<tr>

<th scope="row" class="row-header">Guidance</th>

<td class="content-container"><div><p>Patient self-report for procedures as well as diagnostic studies should be recorded in &quot;Procedure, Performed&quot; template or &quot;Diagnostic Study, Performed&quot; template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE.</p>
</div></td>
</tr>






  
    <tr>

<th colspan="2" scope="row" class="row-header">Measure Population Criteria</th>

</tr>
  
  
  
  
    <tr>
      
        
<th scope="row" class="row-header">Initial Population</th>

      
      <td class="content-container">
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#exm130-fhir-initial-population">Initial Population</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
<th scope="row" class="row-header">Numerator</th>

      
      <td class="content-container">
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#exm130-fhir-numerator">Numerator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
<th scope="row" class="row-header">Denominator</th>

      
      <td class="content-container">
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#exm130-fhir-denominator">Denominator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
<th scope="row" class="row-header">Denominator Exclusion</th>

      
      <td class="content-container">
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#exm130-fhir-denominator-exclusion">Denominator Exclusion</a> 
          
        
      </td>
    </tr>
  

  
  











  <tr>

<th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>

</tr>


<tr>
  
<th scope="row" class="row-header">Supplemental Data Element</th>

  <td class="content-container">
    
    
      
        
          <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
        
        <br/>
      
    
    
      <em>Description</em>: No description provided
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#exm130-fhir-sde-ethnicity">SDE Ethnicity</a> 
      
    
  </td>
</tr>

<tr>
  
<th scope="row" class="row-header">Supplemental Data Element</th>

  <td class="content-container">
    
    
      
        
          <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
        
        <br/>
      
    
    
      <em>Description</em>: No description provided
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#exm130-fhir-sde-payer">SDE Payer</a> 
      
    
  </td>
</tr>

<tr>
  
<th scope="row" class="row-header">Supplemental Data Element</th>

  <td class="content-container">
    
    
      
        
          <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
        
        <br/>
      
    
    
      <em>Description</em>: No description provided
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#exm130-fhir-sde-race">SDE Race</a> 
      
    
  </td>
</tr>

<tr>
  
<th scope="row" class="row-header">Supplemental Data Element</th>

  <td class="content-container">
    
    
      
        
          <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
        
        <br/>
      
    
    
      <em>Description</em>: No description provided
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#exm130-fhir-sde-sex">SDE Sex</a> 
      
    
  </td>
</tr>


<tr>

<th colspan="2" scope="row" class="row-header">Measure Logic</th>

</tr>

<tr>

<th scope="row" class="row-header">Primary Library</th>

<td class="content-container"><a href="Library-EXM130-FHIR.html">EXM130 - Colorectal Cancer Screening Library</a></td>
</tr>




  
  

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library SDE
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-SupplementalDataElements.html">Supplemental Data Elements Libraryversion: null2.0.0)</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqfmeasures/Library/SupplementalDataElements|2.0.000</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library FHIRHelpers
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library Global
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-MATGlobalCommonFunctions.html">MAT Global Common Functions FHIR Libraryversion: null5.0.000)</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library AdultOutpatientEncounters
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-AdultOutpatientEncounters.html">Adult Outpatient Encounters Common Libraryversion: null2.0.000)</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library Hospice
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-Hospice.html">Hospice FHIR Libraryversion: null2.0.000)</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqfmeasures/Library/Hospice|2.0.000</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Code system SNOMEDCT:2017-09
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Colonoscopy
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Fecal Occult Blood Test (FOBT)
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Flexible Sigmoidoscopy
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set FIT DNA
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set CT Colonography
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Payer
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Office Visit
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Annual Wellness Visit
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Preventive Care Services - Established Office Visit, 18 and Up
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Preventive Care Services-Initial Office Visit, 18 and Up
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Home Healthcare Services
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Encounter Inpatient
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Hospice care ambulatory
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Malignant Neoplasm of Colon
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Value set Total Colectomy
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</tt>
    
  </td>
</tr>


  
  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Discharge to home for hospice care (procedure)
        <br/>
      
      <em>Code</em>: 428361000124107
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Discharge to healthcare facility for hospice care (procedure)
        <br/>
      
      <em>Code</em>: 428371000124100
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Measurement Period
    <br/>
    <em>Use</em>: In
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: Period
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: SDE Sex
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: Coding
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Numerator
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Denominator
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: SDE Payer
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: *
    <br/>
    <em>Type</em>: Resource
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Initial Population
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: SDE Ethnicity
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: *
    <br/>
    <em>Type</em>: Coding
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Denominator Exclusion
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: SDE Race
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: *
    <br/>
    <em>Type</em>: Coding
  </td>
</tr>
  
  
  <tr>
    <th colspan="2" scope="row" class="section-header"><a name="effective-data-requirements"> </a>Measure Logic Data Requirements</th>
  </tr>
  
  
<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Coverage
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: period, type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Patient
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/patient.html">Patient</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: extension, value, url
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: period, hospitalization, hospitalization.dischargeDisposition, type, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Condition
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, onset
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/observation.html">Observation</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: effective, code, value, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/observation.html">Observation</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: effective, code, value, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code>
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/servicerequest.html">ServiceRequest</a>
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, authoredOn, intent
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> <code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code>
    <br/> 
  
  
  
   
  </td>
</tr>

  
  <tr>

<th colspan="2" scope="row" class="row-header">Measure Logic Definitions</th>

</tr>
  
          
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="supplementaldataelements-sde-sex"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
  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</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-sde-sex"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-colonoscopy-performed"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Colonoscopy Performed&quot;:
	[Procedure: &quot;Colonoscopy&quot;] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global.&quot;Normalize Interval&quot;(Colonoscopy.performed) ends 10 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-fecal-occult-blood-test-performed"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Fecal Occult Blood Test Performed&quot;:
	[Observation: &quot;Fecal Occult Blood Test (FOBT)&quot;] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global.&quot;Normalize Interval&quot;(FecalOccultResult.effective) during day of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-flexible-sigmoidoscopy-performed"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Flexible Sigmoidoscopy Performed&quot;:
	[Procedure: &quot;Flexible Sigmoidoscopy&quot;] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-fecal-immunochemical-test-dna"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Fecal Immunochemical Test DNA&quot;:
	[Observation: &quot;FIT DNA&quot;] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global.&quot;Normalize Interval&quot;(FitDNA.effective) occurs 3 years or less on or before day of end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-ct-colonography-performed"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;CT Colonography Performed&quot;:
	[Procedure: &quot;CT Colonography&quot;] Colonography
		where Colonography.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colonography.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-numerator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
	exists &quot;Colonoscopy Performed&quot;
		or exists &quot;Fecal Occult Blood Test Performed&quot;
		or exists &quot;Flexible Sigmoidoscopy Performed&quot;
		or exists &quot;Fecal Immunochemical Test DNA&quot;
		or exists &quot;CT Colonography Performed&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-denominator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
	true</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="supplementaldataelements-sde-payer"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-sde-payer"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="adultoutpatientencounters-qualifying-encounters"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> AdultOutpatientEncounters</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Qualifying Encounters&quot;:
	(
    [Encounter: &quot;Office Visit&quot;]
  		union [Encounter: &quot;Annual Wellness Visit&quot;]
  		union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Home Healthcare Services&quot;]
  ) ValidEncounter
		where ValidEncounter.period during &quot;Measurement Period&quot;
  		and ValidEncounter.status  = 'finished'</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
	Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[50, 75]
			and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="supplementaldataelements-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
  (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</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="hospice-has-hospice"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> Hospice</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Hospice&quot;:
	exists (
    [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice
			where DischargeHospice.status = 'finished'
		    and (
	        DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
				    or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
	    	)
				and DischargeHospice.period ends during &quot;Measurement Period&quot;
	)
    or exists (
      [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder
        where HospiceOrder.intent = 'order'
            and HospiceOrder.authoredOn in &quot;Measurement Period&quot;
    )
    or exists (
      [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed
        where HospicePerformed.status = 'completed'
          and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&quot;
    )</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-malignant-neoplasm-ever"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Malignant Neoplasm Ever&quot;:
	[Condition: &quot;Malignant Neoplasm of Colon&quot;] ColorectalCancer
		where Global.&quot;Normalize Interval&quot;(ColorectalCancer.onset) starts on or before end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-total-colectomy-performed"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Total Colectomy Performed&quot;:
	[Procedure: &quot;Total Colectomy&quot;] Colectomy
		where Colectomy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colectomy.performed) starts on or before end of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-denominator-exclusion"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusion&quot;:
	Hospice.&quot;Has Hospice&quot;
		or exists &quot;Malignant Neoplasm Ever&quot;
		or exists &quot;Total Colectomy Performed&quot;</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="supplementaldataelements-sde-race"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
  (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</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="exm130-fhir-sde-race"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> EXM130-FHIR</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;</code></pre>
  </td>

</tr>

  

<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.6 of the sample-content-ig Liquid templates</th>
</tr>
    </tbody>
  </table>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements-exm130"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"/>
      </meta>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <version
                   value="http://snomed.info/sct/731000124108/version/201709"/>
          <code value="428361000124107"/>
          <display value="Discharge to home for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <version
                   value="http://snomed.info/sct/731000124108/version/201709"/>
          <code value="428371000124100"/>
          <display
                   value="Discharge to healthcare facility for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  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>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Colonoscopy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Colonoscopy Performed&quot;:
	[Procedure: &quot;Colonoscopy&quot;] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global.&quot;Normalize Interval&quot;(Colonoscopy.performed) ends 10 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Fecal Occult Blood Test Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Fecal Occult Blood Test Performed&quot;:
	[Observation: &quot;Fecal Occult Blood Test (FOBT)&quot;] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global.&quot;Normalize Interval&quot;(FecalOccultResult.effective) during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Flexible Sigmoidoscopy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Flexible Sigmoidoscopy Performed&quot;:
	[Procedure: &quot;Flexible Sigmoidoscopy&quot;] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Fecal Immunochemical Test DNA"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Fecal Immunochemical Test DNA&quot;:
	[Observation: &quot;FIT DNA&quot;] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global.&quot;Normalize Interval&quot;(FitDNA.effective) occurs 3 years or less on or before day of end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="CT Colonography Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;CT Colonography Performed&quot;:
	[Procedure: &quot;CT Colonography&quot;] Colonography
		where Colonography.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colonography.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
	exists &quot;Colonoscopy Performed&quot;
		or exists &quot;Fecal Occult Blood Test Performed&quot;
		or exists &quot;Flexible Sigmoidoscopy Performed&quot;
		or exists &quot;Fecal Immunochemical Test DNA&quot;
		or exists &quot;CT Colonography Performed&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString value="define &quot;Denominator&quot;:
	true"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdultOutpatientEncounters"/>
        </extension>
        <extension url="name">
          <valueString value="Qualifying Encounters"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Qualifying Encounters&quot;:
	(
    [Encounter: &quot;Office Visit&quot;]
  		union [Encounter: &quot;Annual Wellness Visit&quot;]
  		union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Home Healthcare Services&quot;]
  ) ValidEncounter
		where ValidEncounter.period during &quot;Measurement Period&quot;
  		and ValidEncounter.status  = 'finished'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
	Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[50, 75]
			and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  (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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Hospice"/>
        </extension>
        <extension url="name">
          <valueString value="Has Hospice"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Hospice&quot;:
	exists (
    [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice
			where DischargeHospice.status = 'finished'
		    and (
	        DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
				    or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
	    	)
				and DischargeHospice.period ends during &quot;Measurement Period&quot;
	)
    or exists (
      [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder
        where HospiceOrder.intent = 'order'
            and HospiceOrder.authoredOn in &quot;Measurement Period&quot;
    )
    or exists (
      [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed
        where HospicePerformed.status = 'completed'
          and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Malignant Neoplasm Ever"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Malignant Neoplasm Ever&quot;:
	[Condition: &quot;Malignant Neoplasm of Colon&quot;] ColorectalCancer
		where Global.&quot;Normalize Interval&quot;(ColorectalCancer.onset) starts on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Total Colectomy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Total Colectomy Performed&quot;:
	[Procedure: &quot;Total Colectomy&quot;] Colectomy
		where Colectomy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colectomy.performed) starts on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator Exclusion"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator Exclusion&quot;:
	Hospice.&quot;Has Hospice&quot;
		or exists &quot;Malignant Neoplasm Ever&quot;
		or exists &quot;Total Colectomy Performed&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  (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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="20"/>
        </extension>
      </extension>
      <url
           value="http://hl7.org/fhir/uv/cqfmeasures/Library/effective-data-requirements-exm130"/>
      <version value="1.0.0"/>
      <name value="EffectiveDataRequirements"/>
      <title value="Module Definition Library - EXM130"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <date value="2022-02-22T10:37:03-07:00"/>
      <description
                   value="This library is used as an example module definition in the FHIR Quality Measure Implementation Guide"/>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library SDE"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqfmeasures/Library/SupplementalDataElements|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Global"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library AdultOutpatientEncounters"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Hospice"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqfmeasures/Library/Hospice|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system SNOMEDCT:2017-09"/>
        <resource
                  value="http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Colonoscopy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Fecal Occult Blood Test (FOBT)"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Flexible Sigmoidoscopy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set FIT DNA"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set CT Colonography"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Office Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Annual Wellness Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services - Established Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services-Initial Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Home Healthcare Services"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Encounter Inpatient"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice care ambulatory"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Malignant Neoplasm of Colon"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Total Colectomy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="SDE Sex"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Payer"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Ethnicity"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Denominator Exclusion"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Race"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Coding"/>
      </parameter>
      <dataRequirement>
        <type value="Coverage"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
        <mustSupport value="period"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="extension"/>
        <mustSupport value="value"/>
        <mustSupport value="url"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="period"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <mustSupport value="code"/>
        <mustSupport value="onset"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <mustSupport value="effective"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <mustSupport value="effective"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
        <mustSupport value="code"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="intent"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/uv/cqfmeasures/StructureDefinition/cqfm-populationBasis">
    <valueCode value="boolean"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/software-system-example"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
    <valueCanonical value="#effective-data-requirements-exm130"/>
  </extension>
  <url value="http://hl7.org/fhir/uv/cqfmeasures/Measure/EXM130-FHIR"/>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
    <value value="130"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/>
    <value value="0034"/>
  </identifier>
  <version value="8.0.000"/>
  <name value="EXM130"/>
  <title value="EXM130 - Colorectal Cancer Screening Measure"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2022-02-22"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="venue"/>
      <display value="Venue"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cqfmeasures/CodeSystem/intended-venue-codes"/>
        <code value="ec"/>
        <display value="EC"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <purpose
           value="This measure has been developed to support improvement in clinical care."/>
  <copyright
             value="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."/>
  <approvalDate value="2016-01-01"/>
  <lastReviewDate value="2016-09-01"/>
  <effectivePeriod>
    <start value="2018-01-01"/>
    <end value="2018-12-31"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57024-2"/>
      <display value="Health Quality Measure Document"/>
    </coding>
  </topic>
  <library value="http://hl7.org/fhir/uv/cqfmeasures/Library/EXM130-FHIR"/>
  <disclaimer
              value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; 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]."/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
      <display value="Proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <rationale
             value="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)."/>
  <clinicalRecommendationStatement
                                   value="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)"/>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
      <display value="Increased score indicates improvement"/>
    </coding>
  </improvementNotation>
  <guidance
            value="Patient self-report for procedures as well as diagnostic studies should be recorded in &quot;Procedure, Performed&quot; template or &quot;Diagnostic Study, Performed&quot; template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE."/>
  <group>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exclusion"/>
          <display value="Denominator Exclusion"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exclusion"/>
      </criteria>
    </population>
  </group>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>