BreastCancerScreeningFHIR
type: Measure
node role: treeRoot
id:
  v: BreastCancerScreeningFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm
    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Metadata Title Breast Cancer ScreeningFHIR Version 0.0.001 Short Name CMS125FHIR GUID (Version Independent) urn:uuid:f766afa2-f780-45d2-b224-c1bdb733fa6f GUID (Version Specific) urn:uuid:7c89bd23-97eb-446b-b63a-975b63503b1c CMS Identifier 125FHIR Effective Period 2025-01-01 through 2025-12-31 Status Draft Steward (Publisher) National Committee for Quality Assurance Developer National Committee for Quality Assurance Description Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period Copyright This Physician Performance Measure (Measure) and related data specifications are owned and 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 (e.g., 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) 2012-2024 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 specifica…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428361000124107
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428361000124107
      display:
        v: Discharge to home for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428371000124100
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428371000124100
      display:
        v: Discharge to healthcare facility for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/observation-category
        l: observation-category
      code:
        v: survey
      display:
        v: survey
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/45755-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 45755-6
      display:
        v: Hospice care [Minimum Data Set]
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/373066001
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 373066001
      display:
        v: Yes (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
      display:
        v: Active
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
      display:
        v: Recurrence
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: relapse
      display:
        v: Relapse
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/24028007
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 24028007
      display:
        v: Right (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/7771000
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 7771000
      display:
        v: Left (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/98181-1
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 98181-1
      display:
        v: Medical equipment used
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71802-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71802-3
      display:
        v: Housing status
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/160734000
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 160734000
      display:
        v: Lives in a nursing home (finding)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71007-9
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71007-9
      display:
        v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String

String
v: BreastCancerScreeningFHIR

url:
  v: name
  l: name
value: String
  v: October 1 Two Years Prior to the Measurement Period

url:
  v: statement
  l: statement
value: String
  v: define "October 1 Two Years Prior to the Measurement Period": DateTime((year from start of "Measurement Period" - 2), 10, 1, 0, 0, 0, 0, 0)

url:
  v: displaySequence
  l: displaySequence
value: Integer
  v: 0

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": exists ( ( ( [Observation: "Mammography"] ).isDiagnosticStudyPerformed ( ) ) Mammogram where Mammogram.effective.toInterval ( ) ends during day of Interval["October 1 Two Years Prior to the Measurement Period", end of "Measurement Period"] )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 1
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdultOutpatientEncounters
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Encounters
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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"] union [Encounter: "Virtual Encounter"] union [Encounter: "Telephone Visits"] ).isEncounterPerformed() ) ValidEncounter where ValidEncounter.period.toInterval() during day of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(date from end of "Measurement Period" ) in Interval[52, 74] and Patient.gender = 'female' and exists AdultOutpatientEncounters."Qualifying Encounters"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Hospice
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice Services
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice Services": exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.period.toInterval() ends during day of "Measurement Period" ) or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment where HospiceAssessment.value ~ "Yes (qualifier value)" and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period" // and HospiceOrder.doNotPerform is not true // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447 ) or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period" ) or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Right Mastectomy Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Right Mastectomy Diagnosis": ( [Condition: "Status Post Right Mastectomy"] RightMastectomyProcedure union ( [Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis where exists ( UnilateralMastectomyDiagnosis.bodySite S where S ~ "Right (qualifier value)" ) ) ) RightMastectomy where RightMastectomy.prevalenceInterval ( ) starts on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Right Mastectomy Procedure
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Right Mastectomy Procedure": ( ( [Procedure: "Unilateral Mastectomy Right"] ).isProcedurePerformed ( ) ) UnilateralMastectomyRightPerformed where UnilateralMastectomyRightPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Left Mastectomy Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Left Mastectomy Diagnosis": ( [Condition: "Status Post Left Mastectomy"] union ( [Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis where exists ( UnilateralMastectomyDiagnosis.bodySite S where S ~ "Left (qualifier value)" ) ) ) LeftMastectomy where LeftMastectomy.prevalenceInterval ( ) starts on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Left Mastectomy Procedure
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Left Mastectomy Procedure": ( ( [Procedure: "Unilateral Mastectomy Left"] ).isProcedurePerformed ( ) ) UnilateralMastectomyLeftPerformed where UnilateralMastectomyLeftPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Bilateral Mastectomy Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Bilateral Mastectomy Diagnosis": [Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory where BilateralMastectomyHistory.prevalenceInterval ( ) starts on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Bilateral Mastectomy Procedure
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Bilateral Mastectomy Procedure": ( ( [Procedure: "Bilateral Mastectomy"] ).isProcedurePerformed ( ) ) BilateralMastectomyPerformed where BilateralMastectomyPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Criteria Indicating Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Criteria Indicating Frailty": exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder where FrailtyDeviceOrder.doNotPerform() is not true and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period" ) or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed where EquipmentUsed.value as Concept in "Frailty Device" and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period" ) or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter where FrailtyEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Advanced Illness in Year Before or During Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Advanced Illness in Year Before or During Measurement Period": exists ([Condition: "Advanced Illness"] AdvancedIllnessDiagnosis where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Dementia Medications in Year Before or During Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Dementia Medications in Year Before or During Measurement Period": exists (( ([MedicationRequest: medication in "Dementia Medications"]).isMedicationActive()) DementiaMedication // https://oncprojectracking.healthit.gov/support/browse/CQLIT-449 where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"] // and DementiaMedication.doNotPerform is not true // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447 )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Age 66 or Older with Advanced Illness and Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 or Older with Advanced Illness and Frailty": AgeInYearsAt(date from end of "Measurement Period")>= 66 and "Has Criteria Indicating Frailty" and ( "Has Advanced Illness in Year Before or During Measurement Period" or "Has Dementia Medications in Year Before or During Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Age 66 or Older Living Long Term in a Nursing Home
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 or Older Living Long Term in a Nursing Home": AgeInYearsAt(date from end of "Measurement Period" )>= 66 and ( ( Last( (([Observation: "Housing status"]).isAssessmentPerformed()) HousingStatus where HousingStatus.effective.toInterval() ends on or before day of end of "Measurement Period" sort by end of effective.toInterval() asc )) LastHousingStatus where LastHousingStatus.value ~ "Lives in a nursing home (finding)" ) is not null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PalliativeCare
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Palliative Care in the Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Palliative Care in the Measurement Period": exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: BreastCancerScreeningFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": Hospice."Has Hospice Services" or ( ( exists ( "Right Mastectomy Diagnosis" ) or exists ( "Right Mastectomy Procedure" ) ) and ( exists ( "Left Mastectomy Diagnosis" ) or exists ( "Left Mastectomy Procedure" ) ) ) or exists "Bilateral Mastectomy Diagnosis" or exists "Bilateral Mastectomy Procedure" or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty" or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home" or PalliativeCare."Has Palliative Care in the Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isDiagnosticStudyPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Diagnostic Study, Performed define fluent function isDiagnosticStudyPerformed(Obs List<Observation>): Obs O where O.status in {'final', 'amended', 'corrected' }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isEncounterPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Encounter, Performed //General usage unless required otherwise by measure intent (e.g., follow-up encounters) define fluent function isEncounterPerformed(Enc List<Encounter>): Enc E where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: toInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in QICore, allowing this function to be used across any resource. The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime. If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age, and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later. If the input is a DateTime Interval, the result is the input. If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending immediately before one year later than the date the patient turned the age given as the end of the quantity interval. If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval */ define fluent function toInter…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isAssessmentPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA. //Assessment, Performed define fluent function isAssessmentPerformed(Obs List<Observation>): Obs O where O.status in { 'final', 'amended', 'corrected' } and exists ( O.category ObservationCategory where ( ObservationCategory ) ~ "survey" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionOrder
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Intervention, Order: active and completed only define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>): ServiceRequest S where S.status in { 'active', 'completed' } and S.intent = 'order'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Intervention, Performed define fluent function isInterventionPerformed(Proc List<Procedure>): Proc P where P.status ~ 'completed'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: prevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized prevalence period of a given Condition. @comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary. */ define fluent function prevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()] else (end of condition.abatementInterval()) abatementDate return if abatementDate is null then Interval[start of condition.onset.toInterval(), abatementDate) else Interval[start of condition.onset.toInterval(), abatementDate]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: abatementInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized abatement of a given Condition. @comment: If the abatement element of the Condition is represented as a DateTime, the result is an interval beginning and ending on that DateTime. If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The result is an interval from the date the patient turned that age to immediately before one year later. If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately before one year later than the date the patient turned the ending age of the quantity interval. */ define fluent function abatementInterval(condition Condition): if condition.abatement is DateTime then Interval[condition.abatement as DateTime, condition.abatement as DateTime] else if condition.abatement is Quantity then Interval[Patient.birthDate + (condition.abatement as Quantity), Patient.birthDate + (condition.abatement as Quantity) + 1 year) else if condition.abatement is Interval<Quantity> then Interval[Patient.birthDate + (condition.abatement.low as Quantity), Patient.birthDate + (condition.abatement.high as Quantity) + 1 year) else if condition.abatement is Interval<DateTime> then Interval[condition.abatement.low, condition.abatement.high) else null as Interval<DateTime>
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isProcedurePerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Procedure, Performed define fluent function isProcedurePerformed(Proc List<Procedure>): Proc P where P.status ~ 'completed'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isDeviceOrder
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Device, Order - Personal Use Devices: active and completed only define fluent function isDeviceOrder(DeviceRequest List<DeviceRequest>): DeviceRequest D where D.status in { 'active', 'completed' } and D.intent = 'order'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: doNotPerform
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns true if the given DeviceRequest is a negation (i.e. do not perform this order) */ define fluent function doNotPerform(deviceRequest DeviceRequest): singleton from ( deviceRequest.modifierExtension E where E.url = 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerform' return E.value as Boolean )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isSymptom
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Symptom define fluent function isSymptom(Obs List<Observation>): Obs O where O.status in { 'preliminary', 'final', 'amended', 'corrected' }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isMedicationActive
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Medication, Active define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>): MedicationRequest M where M.status = 'active' and M.intent = 'order'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: medicationRequestPeriod
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function medicationRequestPeriod(Request "MedicationRequest"): Request R let dosage: singleton from R.dosageInstruction, doseAndRate: singleton from dosage.doseAndRate, timing: dosage.timing, frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency), period: Quantity(timing.repeat.period, timing.repeat.periodUnit), doseRange: doseAndRate.dose, doseQuantity: doseAndRate.dose, dose: Coalesce(end of doseRange, doseQuantity), dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0), boundsPeriod: timing.repeat.bounds as Interval<DateTime>, daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value, quantity: R.dispenseRequest.quantity, refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0), startDate: Coalesce( date from start of boundsPeriod, date from R.authoredOn, date from start of R.dispenseRequest.validityPeriod ), totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills) return if startDate is not null and totalDaysSupplied is not null then Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ] else if startDate is not null and boundsPeriod."high" is not null then Interval[startDate, date from end of boundsPeriod] else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: Quantity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /**********************************************************************/ /* Functions in this region are copied from opioid-mme-r4 */ /**********************************************************************/ define function Quantity(value Decimal, unit String): if value is not null then System.Quantity { value: value, unit: unit } else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDaily
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* Goal is to get to number of days Two broad approaches to the calculation: 1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered 2) Based on relevant period, determine a covered interval and calculate the length of that interval in days This topic covers several use cases and illustrates how to calculate Cumulative Medication Duration for each type of medication resource using the supply and frequency approach. */ /* For the first approach, we need to get from frequency to a frequency/day So we define ToDaily */ /* Calculates daily frequency given frequency within a period */ define function ToDaily(frequency System.Integer, period System.Quantity): case period.unit when 'h' then frequency * (24.0 / period.value) when 'min' then frequency * (24.0 / period.value) * 60 when 's' then frequency * (24.0 / period.value) * 60 * 60 when 'd' then frequency * (24.0 / period.value) / 24 when 'wk' then frequency * (24.0 / period.value) / (24 * 7) when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */ when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */ when 'hour' then frequency * (24.0 / period.value) when 'minute' then frequency * (24.0 / period.value) * 60 when 'second' then frequency * (24.0 / period.value) * 60 * 60 when 'day' then frequency * (24.0 / period.value) / 24 when 'week' then frequency * (24.0 / period.value) / (24 * 7) when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */ when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */ when 'hours' then frequency * (24.0 / period.value) when 'minutes' then frequency * (24.0 / period.value) * 60 when 'seconds' then frequency * (24.0 / period.value) * 60 * 60 when 'days' then frequency * (24.0 / period.value) / 24 when 'weeks' then frequency * (24.0 / period.value) / (24 * 7) when 'months' then frequency * (…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

v: EffectiveDataRequirements

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: QICore model information
resource:
  v: http://hl7.org/fhir/us/qicore/Library/QICore-ModelInfo|4.1.1
  l: http://hl7.org/fhir/us/qicore/Library/QICore-ModelInfo

type:
  v: depends-on
display:
  v: Library Status
resource:
  v: https://madie.cms.gov/Library/Status|1.8.000
  l: https://madie.cms.gov/Library/Status

type:
  v: depends-on
display:
  v: Library QICoreCommon
resource:
  v: https://madie.cms.gov/Library/QICoreCommon|2.1.000
  l: https://madie.cms.gov/Library/QICoreCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
  l: https://madie.cms.gov/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library AdultOutpatientEncounters
resource:
  v: https://madie.cms.gov/Library/AdultOutpatientEncounters|4.11.000
  l: https://madie.cms.gov/Library/AdultOutpatientEncounters

type:
  v: depends-on
display:
  v: Library Hospice
resource:
  v: https://madie.cms.gov/Library/Hospice|6.12.000
  l: https://madie.cms.gov/Library/Hospice

type:
  v: depends-on
display:
  v: Library AIFrailLTCF
resource:
  v: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.16.000
  l: https://madie.cms.gov/Library/AdvancedIllnessandFrailty

type:
  v: depends-on
display:
  v: Library CMD
resource:
  v: https://madie.cms.gov/Library/CumulativeMedicationDuration|4.1.000
  l: https://madie.cms.gov/Library/CumulativeMedicationDuration

type:
  v: depends-on
display:
  v: Library PalliativeCare
resource:
  v: https://madie.cms.gov/Library/PalliativeCare|1.11.000
  l: https://madie.cms.gov/Library/PalliativeCare

type:
  v: depends-on
display:
  v: Code system SNOMEDCT
resource:
  v: http://snomed.info/sct
  l: sct

type:
  v: depends-on
display:
  v: Code system ObservationCategoryCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/observation-category
  l: observation-category

type:
  v: depends-on
display:
  v: Code system LOINC
resource:
  v: http://loinc.org
  l: loinc.org

type:
  v: depends-on
display:
  v: Code system ConditionClinicalStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-clinical
  l: condition-clinical

type:
  v: depends-on
display:
  v: Value set Mammography
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018

type:
  v: depends-on
display:
  v: Value set Office Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001

type:
  v: depends-on
display:
  v: Value set Annual Wellness Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240

type:
  v: depends-on
display:
  v: Value set Preventive Care Services Established Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025

type:
  v: depends-on
display:
  v: Value set Preventive Care Services Initial Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023

type:
  v: depends-on
display:
  v: Value set Home Healthcare Services
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016

type:
  v: depends-on
display:
  v: Value set Virtual Encounter
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089

type:
  v: depends-on
display:
  v: Value set Telephone Visits
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080

type:
  v: depends-on
display:
  v: Value set Encounter Inpatient
resource:
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type:
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type:
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  l: qicore-condition
must support:
  v: code
code filter:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070

type:
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  l: qicore-condition
must support:
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must support:
  v: bodySite
code filter:
  path:
    v: code
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071

type:
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  l: qicore-condition
must support:
  v: code
code filter:
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    v: code
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type:
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type:
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  v: code
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074

type:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082

type:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: DeviceRequest
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  l: qicore-devicerequest
must support:
  v: code
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  v: status
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300

type:
  v: MedicationRequest
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  v: medication
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    v: medication
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510

url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
  l: crmi-effectiveDataRequirements
value: Canonical
  v: #effective-data-requirements
  l: effective-data-requirements

use:
  v: usual
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: short-name
system:
  v: https://madie.cms.gov/measure/shortName
  l: shortName
value:
  v: CMS125FHIR

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: version-independent
system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
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    code:
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use:
  v: official
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    code:
      v: publisher
system:
  v: https://madie.cms.gov/measure/cmsId
  l: cmsId
value:
  v: 125FHIR
assigner:
  display:
    v: CMS

v: 0.0.001

v: BreastCancerScreeningFHIR

v: Breast Cancer ScreeningFHIR

v: draft

v: false

v: 2026-03-13T01:50:39+00:00

v: National Committee for Quality Assurance

telecom:
  system:
    v: url
  value:
    v: https://www.ncqa.org/

v: Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period

v: UNKNOWN

v: This measure evaluates primary screening. Do not count biopsies, breast ultrasounds, or MRIs because they are not appropriate methods for primary breast cancer screening. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS125v13. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).

v: This Physician Performance Measure (Measure) and related data specifications are owned and 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 (e.g., 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) 2012-2024 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) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure spe…

start:
  v: 2025-01-01
end:
  v: 2025-12-31

name:
  v: National Committee for Quality Assurance
telecom:
  system:
    v: url
  value:
    v: https://www.ncqa.org/

v: 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].

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/measure-scoring
    l: measure-scoring
  code:
    v: proportion
  display:
    v: Proportion

v: Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al., 2018). In 2015, 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 (Noone et al., 2018). 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 (Noone et al., 2018). 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 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017).

v: The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation) (USPSTF, 2016). 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). The National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) recommend using conventional mammography or DBT for screening women at low, intermediate or high risk for breast cancer (NCCN, 2021) (ACR, 2017).

id:
  v: 64e646302ad653247b573ada
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    l: cqfm-scoring
  value: CodeableConcept
    coding:
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        v: http://terminology.hl7.org/CodeSystem/measure-scoring
        l: measure-scoring
      code:
        v: proportion
      display:
        v: Proportion
extension:
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    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
    l: cqfm-populationBasis
  value: Code
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    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-type
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      code:
        v: process
      display:
        v: Process
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
    l: cqfm-rateAggregation
  value: Code
    v: None
extension:
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    l: cqfm-improvementNotation
  value: CodeableConcept
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      system:
        v: http://terminology.hl7.org/CodeSystem/measure-improvement-notation
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        v: decrease
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        v: increase
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  code:
    coding:
      system:
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        v: initial-population
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        v: Initial Population
  description:
    v: Women 52-74 years of age by the end of the measurement period with a visit during the measurement period
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Initial Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
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        v: denominator
      display:
        v: Denominator
  description:
    v: Equals Initial Population
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: denominator-exclusion
      display:
        v: Denominator Exclusion
  description:
    v: Exclude patients who are in hospice care for any part of the measurement period. Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period.
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator Exclusions
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: numerator
      display:
        v: Numerator
  description:
    v: Women with one or more mammograms any time on or between October 1 two years prior to the measurement period and the end of the measurement period
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Numerator