Clinical Decision Support for Chronic Pain Management and Shared Decision-Making IG
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Clinical Decision Support for Chronic Pain Management and Shared Decision-Making IG, published by CQF. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cds4cpm/ and changes regularly. See the Directory of published versions

CodeSystem: Default MME Conversion Factors

Official URL: http://fhir.org/guides/cqf/cds4cpm/CodeSystem/DefaultMMEConversionFactors Version: 0.1.0
Active as of 2024-03-22 Computable Name: DefaultMMEConversionFactors

Usage:Clinical Focus: Medication requested (situation), Clinical Focus: Chronic pain (finding), Task: MME Calculation

This Code System Supplement defines conversion factors for calculating Morphine Milligram Equivalence (MME) using conversion factors used by default for the CDS4CPM Project. The supplement defines conversions factors for ingredients in one of 3 ways: 1, as a direct conversion factor for the ingredient, 2, as a dose-form-specific conversion factor for the ingredient, and 3, as a dose-ranged conversion factor for the ingredient. See the descriptions for each property for information on how the values are represented for the different conversion factors. For a given ingredient, only one type of property will be present, and the properties will enable a unique conversion factor to be determined if the input is within the expected range. If the input is outside the expected range, implementations should indicate a conversion factor could not be determined from the supplied information. All conversion factors supplied in this supplement are in ‘mg/d’.

This Code system is referenced in the content logical definition of the following value sets:

  • This CodeSystem is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Properties

This code system defines the following properties for its concepts

CodeTypeDescription
conversion-factordecimalDefines the conversion factor for a specific ingredient, when the conversion factor is the same for all dose forms and dose amounts for the ingredient. The value of this property will be the decimal representation of the conversion factor.
dose-form-conversion-factorstringDefines the conversion factor for an ingredient when the conversion factor varies by the dose form of the medication. The value of this property will be a string of the form <dose-form-code>:<conversion-factor>[@<doses-per-day>], e.g. 970789:130, where '970789' is the RxNorm dose form code, and '130' is the decimal representation of the conversion factor. An example of a per-day conversion factor is fentanyl, 316987:7200@0.33333333, where 316987 is RxNorm dose form code, 7200 is the conversion factor, and 0.33333333 is the dosesPerDay, expressed as a decimal with a maximum of 8 digits after the decimal.
dose-range-conversion-factorstringDefines the conversion factor for an ingredient when the conversion factor varies by the overall dose of the medication. The value of this property will be a string of the form <low-value>-<high-value>:<conversion-factor>, e.g. 1-20:4. Note that the low-value or high-value may be a wildcard '*' to indicate the range continues (e.g. '61-*:12' indicates the range is 61 or greater).

Concepts

This code system http://fhir.org/guides/cqf/cds4cpm/CodeSystem/DefaultMMEConversionFactors defines properties on the following codes:

CodeDisplayconversion-factordose-form-conversion-factordose-range-conversion-factor
1819 Buprenorphine316987:12600@0.14285714, 970789:30, 317007:30, 316992:30, 858080:30, 2269578:30
1841 Butorphanol7
2670 Codeine0.15
23088 Dihydrocodeine0.25
4337 Fentanyl316987:7200@0.33333333, 1649574:300, 970789:130, 317007:130, 316992:130, 858080:180, 126542:160, 346163:160, 1797831:160
5489 Hydrocodone1
3423 Hydromorphone4721656:20
237005 Levomethadyl acetate8
6378 Loverphanol tartrate11
6754 Meperidine0.1
6813 Methadone1-20:4, 21-40:8, 41-60:10, 61-*:12
7052 Morphine1
7676 Opium1
7804 Oxycodone1.5
7814 Oxymorphone3
8001 Pentazocine0.37
787390 Tapentadol0.4
10689 Tramadol0.1