Quality Measure Implementation Guide
1.0.1-cibuild - CI Build
Quality Measure Implementation Guide
1.0.1-cibuild - CI Build
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 1.0.1-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cqm/ and changes regularly. See the Directory of published versions
| Page standards status: Informative |
<Measure xmlns="http://hl7.org/fhir">
<id value="EXM124-FHIR"/>
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<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">Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">EXM124 - Cervical Cancer Screening</td>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">9.0.000</td>
</tr>
<tr>
<th scope="row" class="row-header">Short Name</th>
<td class="content-container">Cervical Cancer Screening</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">http://example.org/fhir/us/cqm/Measure/EXM124-FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">http://example.org/fhir/us/cqm/Measure/CMS124v7</td>
</tr>
<tr>
<th scope="row" class="row-header">Identifier</th>
<td class="content-container">124</td>
</tr>
<tr>
<th scope="row" class="row-header">Identifier</th>
<td class="content-container">309</td>
</tr>
<tr>
<th scope="row" class="row-header">Identifier</th>
<td class="content-container">urn:oid:2.16.840.1.113883.4.642.40.61.29.4</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2018-01-01 through 2018-12-31</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">Last Review Date</th>
<td class="content-container">2016-09-01</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">Use Context</th>
<td class="content-container"><span title="{http://terminology.hl7.org/CodeSystem/usage-context-type venue}">Clinical Venue</span> = <span title="Codes:{http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes ec}">EC</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Jurisdiction</th>
<td class="content-container"><span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">Global (Whole world)</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">Steward (Publisher)</th>
<td class="content-container">HL7 International / Clinical Quality Information</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container"><div><p>Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:</p>
<ul>
<li>Women age 21-64 who had cervical cytology performed every 3 years</li>
<li>Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years</li>
</ul>
</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">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 scope="row" class="row-header">Disclaimer</th>
<td class="content-container"><div><p>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 "AS IS" WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Basis</th>
<td class="content-container">boolean</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>Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Howlader et al, 2016). In 2013, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Howlader et al, 2016).
While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Howlader et al, 2016). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 235; by age 50 it becomes 1 in 54; by age 60, it is 1 in 25 (National Business Group on Health, 2011).
In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (National Business Group on Health, 2011). If breast cancer is detected through mammography screening and diagnosed in its earliest stages, treatment may be less expensive (Feig, 2011).</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 (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation).<br/>
The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016)
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016)
The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016)<br/>
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)</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 (Usage)</th>
<td class="content-container">To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.
Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1.
Include only cytology and HPV "co-testing"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure.</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: primary)</th>
</tr>
<tr>
<th scope="row" class="row-header">Summary</th>
<td class="content-container">Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology performed every 3 years
* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: primary-exm124-initial-population
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">Women 23-64 years of age with a visit during the measurement period</p>
<em>Criteria</em>: <a href="#primary-primary-exm124-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: primary-exm124-numerator
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:
* Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test
* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test</p>
<em>Criteria</em>: <a href="#primary-primary-exm124-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: primary-exm124-denominator
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">Equals Initial Population</p>
<em>Criteria</em>: <a href="#primary-primary-exm124-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: primary-exm124-denominator-exclusion
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.
Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients receiving palliative care during the measurement period.</p>
<em>Criteria</em>: <a href="#primary-primary-exm124-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="#exm124-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="#exm124-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>: Race
<br/>
<em>Logic Definition</em>: <a href="#exm124-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="#exm124-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-EXM124.html">EXM124 - Cervical Cancer Screening Library</a></td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: primary)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Initial Population
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm124-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
Patient.gender = 'female'
and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
and exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>
<a href="#exm124-initial-population"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Numerator
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm124-numerator"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Cervical Cytology Within 3 Years"
or exists "HPV Test Within 5 Years for Women Age 30 and Older"</code></pre>
<a href="#exm124-numerator"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Denominator
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm124-denominator"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
<a href="#exm124-denominator"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm124-denominator-exclusion"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Absence of Cervix"</code></pre>
<a href="#exm124-denominator-exclusion"><em>Definition</em></a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> AdultOutpatientEncounters</td>
</tr>
<tr>
<td>
<a name="adultoutpatientencounters-qualifying-encounters"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Qualifying Encounters":
(
[Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
) ValidEncounter
where ValidEncounter.period during "Measurement Period"
and ValidEncounter.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Hospice</td>
</tr>
<tr>
<td>
<a name="hospice-has-hospice"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Hospice":
exists (
[Encounter: "Encounter Inpatient"] DischargeHospice
where DischargeHospice.status = 'finished'
and (
DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.period ends during "Measurement Period"
)
or exists (
[ServiceRequest: "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.intent = 'order'
and HospiceOrder.authoredOn in "Measurement Period"
)
or exists (
[Procedure: "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.status = 'completed'
and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<a name="supplementaldataelements-sde-sex"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
else null
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<a name="supplementaldataelements-sde-payer"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<a name="supplementaldataelements-sde-ethnicity"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
(flatten (
Patient.extension Extension
where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
return Extension.extension
)) E
where E.url = 'ombCategory'
or E.url = 'detailed'
return E.value as Coding</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<a name="supplementaldataelements-sde-race"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
(flatten (
Patient.extension Extension
where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
return Extension.extension
)) E
where E.url = 'ombCategory'
or E.url = 'detailed'
return E.value as Coding</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-sde-sex"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-cervical-cytology-within-3-years"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Cervical Cytology Within 3 Years":
[Observation: "Pap Test"] CervicalCytology
where CervicalCytology.value is not null
and CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }
and Global."Normalize Interval"(CervicalCytology.effective) ends 3 years or less on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-hpv-test-within-5-years-for-women-age-30-and-older"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "HPV Test Within 5 Years for Women Age 30 and Older":
[Observation: "HPV Test"] HPVTest
where HPVTest.value is not null
and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }
and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of Global."Normalize Interval"(HPVTest.effective))>= 30
and Global."Normalize Interval"(HPVTest.effective) ends 5 years or less on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-numerator"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Cervical Cytology Within 3 Years"
or exists "HPV Test Within 5 Years for Women Age 30 and Older"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
Patient.gender = 'female'
and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
and exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-denominator"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-sde-payer"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-sde-ethnicity"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-absence-of-cervix"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Absence of Cervix":
([Procedure: "Hysterectomy with No Residual Cervix"] NoCervixProcedure
where Global."Normalize Interval"(NoCervixProcedure.performed) ends on or before end of "Measurement Period"
and NoCervixProcedure.status = 'completed'
)
union [Condition : "Congenital absence of cervix (disorder)"] NoCervixBirth
where Global."Normalize Interval"(NoCervixBirth.onset) starts on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-denominator-exclusion"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Absence of Cervix"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM124</td>
</tr>
<tr>
<td>
<a name="exm124-sde-race"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> MATGlobalCommonFunctions</td>
</tr>
<tr>
<td>
<a name="matglobalcommonfunctions-calendarageinyearsat"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime):
years between ToDate(BirthDateTime)and ToDate(AsOf)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> MATGlobalCommonFunctions</td>
</tr>
<tr>
<td>
<a name="matglobalcommonfunctions-todate"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function "ToDate"(Value DateTime):
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value AdministrativeGender): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ObservationStatus): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-todate"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDate(value date): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tointerval"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value EncounterStatus): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-toconcept"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tocode"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ServiceRequestIntent): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-todatetime"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDateTime(value dateTime): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ProcedureStatus): value.value</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Code System</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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Pap Test
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1017/expansion">Pap Test</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set HPV Test
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1059/expansion">HPV Test</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Office Visit
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Annual Wellness Visit
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services - Established Office Visit, 18 and Up
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services Established Office Visit, 18 and Up</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services-Initial Office Visit, 18 and Up
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services Initial Office Visit, 18 and Up</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Home Healthcare Services
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Payer
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Encounter Inpatient
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospice care ambulatory
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a>
<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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hysterectomy with No Residual Cervix
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1014/expansion">Hysterectomy with No Residual Cervix</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014</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">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Congenital absence of cervix (disorder)
<br/>
<em>Code</em>: 37687000
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</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 Elementsversion: null2.0.000)</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/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>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/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/cqm/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/cqm/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/cqm/Library/Hospice|2.0.000</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</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>: url, extension, value
<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>: code, value, status, effective
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1017/expansion">Pap Test</a>
<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>: code, value, status, effective
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1059/expansion">HPV Test</a>
<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, period, 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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a>
<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, period, 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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a>
<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, period, 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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services Established Office Visit, 18 and Up</a>
<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, period, 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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services Initial Office Visit, 18 and Up</a>
<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, period, 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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a>
<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, status, hospitalization, hospitalization.dischargeDisposition, period
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a>
<br/>
</td>
</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>: type, period
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
<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, intent, authoredOn
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a>
<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, status, performed
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a>
<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> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1014/expansion">Hysterectomy with No Residual Cervix</a>
<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>Code(s)</em>:
<a href="http://snomed.info/id/37687000">SNOMED CT 37687000</a>: Congenital absence of cervix (disorder) (version = http://snomed.info/sct/731000124108/version/201709 )
</span>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.9 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<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-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<version
value="http://snomed.info/sct/731000124108/version/201709"/>
<code value="37687000"/>
<display value="Congenital absence of cervix (disorder)"/>
</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 "SDE Sex":
case
when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Cervical Cytology Within 3 Years"/>
</extension>
<extension url="statement">
<valueString
value="define "Cervical Cytology Within 3 Years":
[Observation: "Pap Test"] CervicalCytology
where CervicalCytology.value is not null
and CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }
and Global."Normalize Interval"(CervicalCytology.effective) ends 3 years or less on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString
value="HPV Test Within 5 Years for Women Age 30 and Older"/>
</extension>
<extension url="statement">
<valueString
value="define "HPV Test Within 5 Years for Women Age 30 and Older":
[Observation: "HPV Test"] HPVTest
where HPVTest.value is not null
and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }
and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of Global."Normalize Interval"(HPVTest.effective))>= 30
and Global."Normalize Interval"(HPVTest.effective) ends 5 years or less on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
exists "Cervical Cytology Within 3 Years"
or exists "HPV Test Within 5 Years for Women Age 30 and Older""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</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 "Qualifying Encounters":
(
[Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
) ValidEncounter
where ValidEncounter.period during "Measurement Period"
and ValidEncounter.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
Patient.gender = 'female'
and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
and exists AdultOutpatientEncounters."Qualifying Encounters""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</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 "SDE Payer":
[Coverage: type in "Payer"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</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 "SDE Ethnicity":
(flatten (
Patient.extension Extension
where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
return Extension.extension
)) E
where E.url = 'ombCategory'
or E.url = 'detailed'
return E.value as Coding"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</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 "Has Hospice":
exists (
[Encounter: "Encounter Inpatient"] DischargeHospice
where DischargeHospice.status = 'finished'
and (
DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.period ends during "Measurement Period"
)
or exists (
[ServiceRequest: "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.intent = 'order'
and HospiceOrder.authoredOn in "Measurement Period"
)
or exists (
[Procedure: "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.status = 'completed'
and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Absence of Cervix"/>
</extension>
<extension url="statement">
<valueString
value="define "Absence of Cervix":
([Procedure: "Hysterectomy with No Residual Cervix"] NoCervixProcedure
where Global."Normalize Interval"(NoCervixProcedure.performed) ends on or before end of "Measurement Period"
and NoCervixProcedure.status = 'completed'
)
union [Condition : "Congenital absence of cervix (disorder)"] NoCervixBirth
where Global."Normalize Interval"(NoCervixBirth.onset) starts on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Absence of Cervix""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</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 "SDE Race":
(flatten (
Patient.extension Extension
where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
return Extension.extension
)) E
where E.url = 'ombCategory'
or E.url = 'detailed'
return E.value as Coding"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM124"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value AdministrativeGender): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ObservationStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="MATGlobalCommonFunctions"/>
</extension>
<extension url="name">
<valueString value="CalendarAgeInYearsAt"/>
</extension>
<extension url="statement">
<valueString
value="define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime):
years between ToDate(BirthDateTime)and ToDate(AsOf)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="MATGlobalCommonFunctions"/>
</extension>
<extension url="name">
<valueString value="ToDate"/>
</extension>
<extension url="statement">
<valueString
value="define function "ToDate"(Value DateTime):
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToDate"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDate(value date): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value EncounterStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ServiceRequestIntent): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToDateTime"/>
</extension>
<extension url="statement">
<valueString
value="define function ToDateTime(value dateTime): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ProcedureStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource
value="http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Global"/>
<resource
value="http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library AdultOutpatientEncounters"/>
<resource
value="http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Hospice"/>
<resource value="http://hl7.org/fhir/uv/cqm/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 Pap Test"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HPV Test"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"/>
</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 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 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 Hysterectomy with No Residual Cervix"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014"/>
</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="Patient"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<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"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<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"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<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"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<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"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<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="type"/>
<mustSupport value="status"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="period"/>
<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="Coverage"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<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="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="authoredOn"/>
<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="status"/>
<mustSupport value="performed"/>
<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/2.16.840.1.113883.3.464.1003.198.12.1014"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<mustSupport value="onset"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://snomed.info/sct"/>
<version
value="http://snomed.info/sct/731000124108/version/201709"/>
<code value="37687000"/>
<display value="Congenital absence of cervix (disorder)"/>
</code>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<url value="http://hl7.org/fhir/uv/cqm/Measure/EXM124-FHIR"/>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
<value value="124"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="http://example.org/fhir/us/cqm/Measure/EXM124-FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="http://example.org/fhir/us/cqm/Measure/CMS124v7"/>
</identifier>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<value value="Cervical Cancer Screening"/>
</identifier>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/mips"/>
<value value="309"/>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.40.61.29.4"/>
</identifier>
<version value="9.0.000"/>
<name value="EXM124"/>
<title value="EXM124 - Cervical Cancer Screening"/>
<status value="active"/>
<experimental value="true"/>
<date value="2025-08-13"/>
<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 women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology performed every 3 years
* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="venue"/>
<display value="Clinical Venue"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/uv/cqm/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."/>
<usage
value="To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.
Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1.
Include only cytology and HPV "co-testing"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure."/>
<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/cqm/Library/EXM124"/>
<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 "AS IS" WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<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="Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Howlader et al, 2016). In 2013, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Howlader et al, 2016).
While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Howlader et al, 2016). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 235; by age 50 it becomes 1 in 54; by age 60, it is 1 in 25 (National Business Group on Health, 2011).
In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (National Business Group on Health, 2011). If breast cancer is detected through mammography screening and diagnosed in its earliest stages, treatment may be less expensive (Feig, 2011)."/>
<clinicalRecommendationStatement
value="The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation).
The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016)
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016)
The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016)
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)"/>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</improvementNotation>
<group>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId">
<valueString value="primary"/>
</extension>
<description
value="Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology performed every 3 years
* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years"/>
<population>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm124-initial-population"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Women 23-64 years of age with a visit during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm124-numerator"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:
* Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test
* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm124-denominator"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm124-denominator-exclusion"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.
Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients receiving palliative care during the measurement period."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusion"/>
</criteria>
</population>
</group>
<supplementalData>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-ethnicity"/>
</extension>
<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>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-payer"/>
</extension>
<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>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-race"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="Race"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-sex"/>
</extension>
<code>
<text value="Sex"/>
</code>
<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>
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.uv.cqm#1.0.1-cibuild based on FHIR 4.0.1. Generated 2025-09-23
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