Id: DiabetesHemoglobinA1cHbA1cPoorControl9FHIR Version: 0.1.0 Url: DiabetesHemoglobinA1cHbA1cPoorControl9FHIR Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2021-04-23 15:57:06+0000 Publisher: Clinical Quality Framework Description: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)FHIR Jurisdiction: 001 Related Artifacts: Dependencies http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRHelpers|4.1.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SupplementalDataElementsFHIR4|2.0.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/MATGlobalCommonFunctionsFHIR4|6.0.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/AdultOutpatientEncountersFHIR4|2.0.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/HospiceFHIR4|2.0.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/AdvancedIllnessandFrailtyExclusionECQMFHIR4|5.12.000 http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SurveillanceDataElementsFHIR4|1.0.000 AlphoraCommon PalliativeCareFHIR http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRCommon|1.1.000 LOINC Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes CPT Observation Category Codes Diabetes Ethnicity HbA1c Laboratory Test Annual Wellness Visit Home Healthcare Services Office Visit Preventive Care Services - Established Office Visit, 18 and Up Preventive Care Services-Initial Office Visit, 18 and Up Nutrition Services Telephone Visits Parameters: Name Type Min Max In/Out Measurement Period Period 0 1 In Patient Patient 0 1 Out SDE Ethnicity Coding 0 * Out SDE Payer Resource 0 * Out SDE Race Coding 0 * Out SDE Sex Coding 0 1 Out SDE Age integer 0 1 Out Stratifier Age Group Coding 0 1 Out SDE State of Residence string 0 1 Out SDE Postal Code of Residence string 0 1 Out SDE Food Insecurity Risk Status CodeableConcept 0 1 Out Qualifying Encounters Encounter 0 * Out Initial Population boolean 0 1 Out Denominator boolean 0 1 Out Denominator Exclusions boolean 0 1 Out Has HbA1c Lab Test Observation 0 * Out Most Recent HbA1c Lab Test Observation 0 1 Out Has Most Recent HbA1c Without Result boolean 0 1 Out Has Most Recent Elevated HbA1c boolean 0 1 Out Has No Record Of HbA1c boolean 0 1 Out Numerator boolean 0 1 Out Data Requirements: Type Profile MS Code Filter Patient http://hl7.org/fhir/StructureDefinition/Patient Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006 Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type system: http://www.ama-assn.org/go/cpt code: 97802 display: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type system: http://www.ama-assn.org/go/cpt code: 97803 display: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type system: http://www.ama-assn.org/go/cpt code: 97804 display: Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets code: G0270 display: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets code: G0271 display: Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes Encounter http://hl7.org/fhir/StructureDefinition/Encounter ;;; code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080 Condition http://hl7.org/fhir/StructureDefinition/Condition ; code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001 Observation http://hl7.org/fhir/StructureDefinition/Observation ;; code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013 Content: text/cql /*#xD; FHIR Translation of CMS122: Diabetes: HemoglobinA1c Poor Control#xD; */#xD; library DiabetesHemoglobinA1cHbA1cPoorControl9FHIR version '0.0.001'#xD; #xD; using FHIR version '4.0.1'#xD; #xD; include FHIRHelpers version '4.1.000' called FHIRHelpers#xD; include SupplementalDataElementsFHIR4 version '2.0.000' called SDE#xD; include MATGlobalCommonFunctionsFHIR4 version '6.0.000' called Global#xD; include AdultOutpatientEncountersFHIR4 version '2.0.000' called AdultOutpatientEncounters#xD; include HospiceFHIR4 version '2.0.000' called Hospice#xD; include AdvancedIllnessandFrailtyExclusionECQMFHIR4 version '5.12.000' called Frailty#xD; include SurveillanceDataElementsFHIR4 version '1.0.000' called SurveillanceDataElements#xD; include AlphoraCommon called AC#xD; include PalliativeCareFHIR called PalliativeCare#xD; include FHIRCommon version '1.1.000' called FC #xD; #xD; codesystem "LOINC": 'http://loinc.org'#xD; codesystem "HCPCS": 'http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets'#xD; codesystem "CPT": 'http://www.ama-assn.org/go/cpt'#xD; codesystem "ObservationCategoryCodes": 'http://terminology.hl7.org/CodeSystem/observation-category'#xD; #xD; valueset "Diabetes": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001'#xD; valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'#xD; valueset "HbA1c Laboratory Test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013'#xD; valueset "Annual Wellness Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240'#xD; valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'#xD; valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'#xD; 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'#xD; 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'#xD; valueset "Nutrition Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006'#xD; valueset "Telephone Visits": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080'#xD; #xD; code "Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes": 'G0271' from "HCPCS" display 'Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes'#xD; code "Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes": '97804' from "CPT" display 'Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes'#xD; code "Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes": '97802' from "CPT" display 'Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes'#xD; code "Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes": '97803' from "CPT" display 'Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes'#xD; code "Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes": 'G0270' from "HCPCS" display 'Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes'#xD; code "laboratory": 'laboratory' from "ObservationCategoryCodes" display 'laboratory'#xD; code "Birth date": '21112-8' from "LOINC" display 'Birth date'#xD; #xD; parameter "Measurement Period" default Interval[@2025-01-01T00:00:00.0, @2026-01-01T00:00:00.0)#xD; #xD; context Patient#xD; #xD; define "SDE Ethnicity":#xD; SDE."SDE Ethnicity"#xD; #xD; define "SDE Payer":#xD; SDE."SDE Payer"#xD; #xD; define "SDE Race":#xD; SDE."SDE Race"#xD; #xD; define "SDE Sex":#xD; SDE."SDE Sex"#xD; #xD; define "SDE Age":#xD; SurveillanceDataElements."Age"#xD; #xD; define "Stratifier Age Group":#xD; SurveillanceDataElements."Age Group"#xD; #xD; define "SDE State of Residence":#xD; SurveillanceDataElements."State of Residence"#xD; #xD; define "SDE Postal Code of Residence":#xD; SurveillanceDataElements."Postal Code of Residence"#xD; #xD; define "SDE Food Insecurity Risk Status":#xD; SurveillanceDataElements."Food Insecurity Risk Status"#xD; #xD; define "Initial Population":#xD; AgeInYearsAt(end of "Measurement Period") in Interval[18, 75]#xD; and exists("Qualifying Encounters")#xD; and exists( (AC.QualifiedConditions([Condition: "Diabetes"])) Diabetes#xD; where FC.ToPrevalenceInterval(Diabetes) overlaps "Measurement Period" )#xD; #xD; define "Qualifying Encounters":#xD; (#xD; [Encounter: "Office Visit"]#xD; union [Encounter: "Annual Wellness Visit"]#xD; union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]#xD; union [Encounter: "Preventive Care Services - Initial Office Visit, 18 and Up"]#xD; union [Encounter: "Home Healthcare Services"]#xD; union [Encounter: "Nutrition Services"]#xD; union [Encounter: "Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes"]#xD; union [Encounter: "Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes"]#xD; union [Encounter: "Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes"]#xD; union [Encounter: "Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes"]#xD; union [Encounter: "Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes"]#xD; union [Encounter: "Telephone Visits"]#xD; ) ValidEncounters#xD; where ValidEncounters.period during "Measurement Period"#xD; and ValidEncounters.status ~ 'finished'#xD; #xD; define "Denominator":#xD; "Initial Population"#xD; #xD; define "Denominator Exclusions":#xD; Hospice."Has Hospice"#xD; or Frailty."Is Age 66 or Older Living Long Term in a Nursing Home"#xD; or Frailty."Is Age 66 or Older with Advanced Illness and Frailty"#xD; or PalliativeCare."Palliative Care in the Measurement Period"#xD; #xD; define "Numerator":#xD; "Has Most Recent HbA1c Without Result"#xD; or "Has Most Recent Elevated HbA1c"#xD; or "Has No Record Of HbA1c"#xD; #xD; define "Has HbA1c Lab Test":#xD; (AC.LaboratoryObservation([Observation: "HbA1c Laboratory Test"]))#xD; #xD; define "Most Recent HbA1c Lab Test":#xD; AC.MostRecent("Has HbA1c Lab Test" HbA1cTest#xD; where FC.ToInterval(HbA1cTest.effective) during "Measurement Period")#xD; #xD; define "Has Most Recent Elevated HbA1c":#xD; "Most Recent HbA1c Lab Test".value >= 9 '%'#xD; #xD; define "Has Most Recent HbA1c Without Result":#xD; ("Most Recent HbA1c Lab Test" is not null)#xD; and ("Most Recent HbA1c Lab Test".value is null)#xD; #xD; define "Has No Record Of HbA1c":#xD; not exists("Has HbA1c Lab Test")#xD; Content: application/elm+xml Encoded data (99988 characters) Content: application/elm+json Encoded data (175352 characters)
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)FHIR
Value set Preventive Care Services - Established Office Visit, 18 and Up
Value set Preventive Care Services - Initial Office Visit, 18 and Up
Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes