Quality Measure Implementation Guide
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Quality Measure Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cqm/ and changes regularly. See the Directory of published versions

Library: CCS Component Library

Official URL: http://hl7.org/fhir/uv/cqm/Library/CCSComponent Version: 0.0.001
Standards status: Trial-use Draft as of 2026-04-03 Maturity Level: 4 Computable Name: CCSComponent
Other Identifiers: OID:2.16.840.1.113883.4.642.40.61.28.5

This library is the primary measure library for the Cervical Cancer Screening component of the composite measure examples in this implementation guide.

Metadata
Title CCS Component Library
Version 0.0.001
Identifier urn:oid:2.16.840.1.113883.4.642.40.61.28.5
Status Draft
Jurisdiction 001 from http://unstats.un.org/unsd/methods/m49/m49.htm
Steward (Publisher) HL7 International / Clinical Quality Information
Description

This library is the primary measure library for the Cervical Cancer Screening component of the composite measure examples in this implementation guide.
Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Dependency Description: Library SDE
Resource: Supplemental Data Elementsversion: null2.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000
Dependency Description: Library Global
Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000
Dependency Description: Library AdultOutpatientEncounters
Resource: Adult Outpatient Encounters Common Libraryversion: null2.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000
Dependency Description: Library Hospice
Resource: Hospice FHIR Libraryversion: null2.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/Hospice|2.0.000
Dependency Description: Library Frailty
Resource: Advanced Illness and Frailty Exclusion Libraryversion: null5.12.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/AdvancedIllnessandFrailtyExclusion|5.12.000
Dependency Description: Code System LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Value Set Acute Inpatient
Resource: Acute Inpatient
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083
Dependency Description: Value Set Advanced Illness
Resource: Advanced Illness
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
Dependency Description: Value Set Annual Wellness Visit
Resource: Annual Wellness Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Dependency Description: Value Set Care Services in Long-Term Residential Facility
Resource: Care Services in Long Term Residential Facility
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014
Dependency Description: Value Set Colonoscopy
Resource: Colonoscopy
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
Dependency Description: Value Set CT Colonography
Resource: CT Colonography
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
Dependency Description: Value Set Dementia Medications
Resource: Dementia Medications
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510
Dependency Description: Value Set Discharged to Health Care Facility for Hospice Care
Resource: Discharged to Health Care Facility for Hospice Care
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207
Dependency Description: Value Set Discharged to Home for Hospice Care
Resource: Discharged to Home for Hospice Care
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209
Dependency Description: Value Set ED
Resource: ED
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085
Dependency Description: Value Set Encounter Inpatient
Resource: Encounter Inpatient
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Dependency Description: Value Set Fecal Occult Blood Test (FOBT)
Resource: Fecal Occult Blood Test (FOBT)
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
Dependency Description: Value Set FIT DNA
Resource: sDNA FIT Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
Dependency Description: Value Set Flexible Sigmoidoscopy
Resource: Flexible Sigmoidoscopy
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
Dependency Description: Value Set Frailty Device
Resource: Frailty Device
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300
Dependency Description: Value Set Frailty Diagnosis
Resource: Frailty Diagnosis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074
Dependency Description: Value Set Frailty Encounter
Resource: Frailty Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088
Dependency Description: Value Set Frailty Symptom
Resource: Frailty Symptom
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075
Dependency Description: Value Set Home Healthcare Services
Resource: Home Healthcare Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Dependency Description: Value Set Hospice care ambulatory
Resource: Hospice Care Ambulatory
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Dependency Description: Value Set Malignant Neoplasm of Colon
Resource: Malignant Neoplasm of Colon
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
Dependency Description: Value Set Nonacute Inpatient
Resource: Nonacute Inpatient
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084
Dependency Description: Value Set Nursing Facility Visit
Resource: Nursing Facility Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012
Dependency Description: Value Set Observation
Resource: Observation
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086
Dependency Description: Value Set Office Visit
Resource: Office Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Dependency Description: Value Set Outpatient
Resource: Outpatient
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087
Dependency Description: Value Set Preventive Care Services - Established Office Visit, 18 and Up
Resource: Preventive Care Services Established Office Visit, 18 and Up
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Dependency Description: Value Set Preventive Care Services-Initial Office Visit, 18 and Up
Resource: Preventive Care Services Initial Office Visit, 18 and Up
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Dependency Description: Value Set Total Colectomy
Resource: Total Colectomy
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
Data Requirement Type: Procedure
Profile(s): Procedure
Code Filter(s):
Path: code
ValueSet: Flexible Sigmoidoscopy
Data Requirement Type: Procedure
Profile(s): Procedure
Code Filter(s):
Path: code
ValueSet: CT Colonography
Data Requirement Type: Procedure
Profile(s): Procedure
Code Filter(s):
Path: code
ValueSet: Total Colectomy
Data Requirement Type: Observation
Profile(s): Observation
Code Filter(s):
Path: code
ValueSet: Fecal Occult Blood Test (FOBT)
Data Requirement Type: Observation
Profile(s): Observation
Code Filter(s):
Path: code
ValueSet: sDNA FIT Test
Data Requirement Type: Procedure
Profile(s): Procedure
Code Filter(s):
Path: code
ValueSet: Colonoscopy
Data Requirement Type: Condition
Profile(s): Condition
Code Filter(s):
Path: code
ValueSet: Malignant Neoplasm of Colon
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
Patient Out 0..1 Patient
SDE Ethnicity Out 0..* Coding
SDE Payer Out 0..* Resource
SDE Race Out 0..* Coding
SDE Sex Out 0..1 Coding
Initial Population Out 0..1 boolean
Denominator Out 0..1 boolean
Flexible Sigmoidoscopy Performed Out 0..* Procedure
CT Colonography Performed Out 0..* Procedure
Total Colectomy Performed Out 0..* Procedure
Fecal Occult Blood Test Performed Out 0..* Observation
Fecal Immunochemical Test DNA Out 0..* Observation
Colonoscopy Performed Out 0..* Procedure
Numerator Out 0..1 boolean
Malignant Neoplasm Out 0..* Condition
Denominator Exclusion Out 0..1 boolean
Library Content
CQL Content 
/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.
*/
library CCSComponent version '0.0.001'

using FHIR version '4.0.1'

include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers

include SupplementalDataElements version '2.0.000' called SDE
include MATGlobalCommonFunctions version '5.0.000' called Global
include AdultOutpatientEncounters version '2.0.000' called AdultOutpatientEncounters
include Hospice version '2.0.000' called Hospice
include AdvancedIllnessandFrailtyExclusion version '5.12.000' called Frailty

codesystem "LOINC": 'http://loinc.org'

valueset "Acute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083'
valueset "Advanced Illness": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082'
valueset "Annual Wellness Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240'
valueset "Care Services in Long-Term Residential Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014'
valueset "Colonoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020'
valueset "CT Colonography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038'
valueset "Dementia Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510'
valueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'
valueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'
valueset "ED": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085'
valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset "Fecal Occult Blood Test (FOBT)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011'
valueset "FIT DNA": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039'
valueset "Flexible Sigmoidoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010'
valueset "Frailty Device": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300'
valueset "Frailty Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074'
valueset "Frailty Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088'
valueset "Frailty Symptom": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075'
valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'
valueset "Hospice care ambulatory": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15'
valueset "Malignant Neoplasm of Colon": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001'
valueset "Nonacute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084'
valueset "Nursing Facility Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012'
valueset "Observation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Outpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087'
valueset "Preventive Care Services - Established Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025'
valueset "Preventive Care Services-Initial Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023'
valueset "Total Colectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019'

code "Birth date": '21112-8' from "LOINC" display 'Birth date'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Payer":
  SDE."SDE Payer"

define "SDE Race":
  SDE."SDE Race"

define "SDE Sex":
  SDE."SDE Sex"

define "Initial Population":
  Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of "Measurement Period" ) in Interval[50, 75]
      and exists AdultOutpatientEncounters."Qualifying Encounters"

define "Denominator":
  "Initial Population"

define "Flexible Sigmoidoscopy Performed":
  [Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
      where FlexibleSigmoidoscopy.status = 'completed'
        and Global."Normalize Interval" ( FlexibleSigmoidoscopy.performed ) ends 5 years or less on or before
        end of "Measurement Period"

define "CT Colonography Performed":
  [Procedure: "CT Colonography"] Colonography
      where Colonography.status = 'completed'
        and Global."Normalize Interval" ( Colonography.performed ) ends 5 years or less on or before
        end of "Measurement Period"

define "Total Colectomy Performed":
  [Procedure: "Total Colectomy"] Colectomy
      where Colectomy.status = 'completed'
        and Global."Normalize Interval" ( Colectomy.performed ) starts on or before
        end of "Measurement Period"

define "Fecal Occult Blood Test Performed":
  [Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
      where FecalOccultResult.status in { 'final', 'amended', 'corrected', 'preliminary' }
        and FecalOccultResult.value is not null
        and Global."Normalize Interval" ( FecalOccultResult.effective ) during day of "Measurement Period"

define "Fecal Immunochemical Test DNA":
  [Observation: "FIT DNA"] FitDNA
      where FitDNA.status in { 'final', 'amended', 'corrected', 'preliminary' }
        and FitDNA.value is not null
        and Global."Normalize Interval" ( FitDNA.effective ) occurs 3 years or less on or before day of
        end of "Measurement Period"

define "Colonoscopy Performed":
  [Procedure: "Colonoscopy"] Colonoscopy
      where Colonoscopy.status = 'completed'
        and Global."Normalize Interval" ( Colonoscopy.performed ) ends 10 years or less on or before
        end of "Measurement Period"

define "Numerator":
  exists "Colonoscopy Performed"
      or exists "Fecal Occult Blood Test Performed"
      or exists "Flexible Sigmoidoscopy Performed"
      or exists "Fecal Immunochemical Test DNA"
      or exists "CT Colonography Performed"

define "Malignant Neoplasm":
  [Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
      where Global."Prevalence Period" ( ColorectalCancer ) starts on or before
      end of "Measurement Period"

define "Denominator Exclusion":
  Hospice."Has Hospice"
      or exists "Malignant Neoplasm"
      or exists "Total Colectomy Performed"
      or Frailty."Advanced Illness and Frailty Exclusion Not Including Over Age 80"
        and Frailty."Long Term Care Periods Longer Than 90 Consecutive Days"
ELM XML Content 
Encoded data
ELM JSON Content 
Encoded data
Generated using version 0.5.4 of the sample-content-ig Liquid templates