CMS Draft FHIR Measures
2024.1.0 - CI Build

CMS Draft FHIR Measures, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2024/ and changes regularly. See the Directory of published versions

Measure: Controlling High Blood PressureFHIR

Official URL: https://madie.cms.gov/Measure/ControllingHighBloodPressureFHIR Version: 0.1.000
Draft as of 2026-03-13 Responsible: National Committee for Quality Assurance Computable Name: ControllingHighBloodPressureFHIR
Other Identifiers: Short Name (use: usual, ), UUID:9017d914-6748-45a9-bff1-8392ed644a7b (use: official, ), UUID:f573fb8f-4907-4ed7-bc04-09d9a3f36268 (use: official, ), Publisher (use: official, )

Copyright/Legal: 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 specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use.

This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation.

ICD-10 copyright 2024 World Health Organization. All Rights Reserved.

Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product.

“HL7” is the registered trademark of Health Level Seven International.

Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period

UNKNOWN

Metadata
Title Controlling High Blood PressureFHIR
Version 0.1.000
Short Name CMS165FHIR
GUID (Version Independent) urn:uuid:9017d914-6748-45a9-bff1-8392ed644a7b
GUID (Version Specific) urn:uuid:f573fb8f-4907-4ed7-bc04-09d9a3f36268
CMS Identifier 165FHIR
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 patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during 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 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 specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use.

This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation.

ICD-10 copyright 2024 World Health Organization. All Rights Reserved.

Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product.

“HL7” is the registered trademark of Health Level Seven International.

Disclaimer

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].

Measure Scoring Proportion
Rationale

High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2023). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults >= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in National Health and Nutrition Examination Survey (NHANES), the estimated age-adjusted proportion with controlled blood pressure (BP) increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022).

HBP increases risks of heart disease and stroke which are two of the leading causes of death in the US (CDC, 2023). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2021). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022).

HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures (SBP) of >= 160 mmHg could be effective and cost-saving (Moran et al., 2015).

Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of <120 mmHg compared to a SBP goal of <140 mmHg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015).

Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.

Clinical Recommendation Statement

U.S. Preventive Services Task Force (USPSTF) (2021):

  • The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation.

American College of Cardiology/American Heart Association (2017):

  • For adults with confirmed hypertension and known cardiovascular disease (CVD) or 10-year atherosclerotic cardiovascular disease (ASCVD) event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure))

  • For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)).

American Academy of Family Physicians (2022):

  • Treat adults who have hypertension to a standard blood pressure target (less than 140/90 mm Hg) to reduce the risk of all-cause and cardiovascular mortality (strong recommendation; high-quality evidence). Treating to a lower blood pressure target (less than 135/85 mm Hg) does not provide additional benefit at preventing mortality; however, a lower blood pressure target could be considered based on patient preferences and values. (Grade: strong recommendation, Quality of evidence: high)

  • Consider treating adults who have hypertension to a lower blood pressure target (less than 135/85 mm Hg) to reduce risk of myocardial infarction (weak recommendation; moderate-quality evidence). Although treatment to a standard blood pressure target (less than 140/90 mm Hg) reduced the risk of myocardial infarction, there was a small additional benefit observed with a lower blood pressure target. There was no observed additional benefit in preventing stroke with the lower blood pressure target. (Grade: weak recommendation, Quality of evidence: low)

American Diabetes Association (2022):

  • For individuals with diabetes and hypertension at higher cardiovascular risk (existing atherosclerotic cardiovascular disease or 10-year atherosclerotic cardiovascular disease risk >=15 percent), a blood pressure target of <130/80 mmHg may be appropriate, if it can be safely attained (Level of evidence: B)

  • For individuals with diabetes and hypertension at lower risk for cardiovascular disease (10-year atherosclerotic cardiovascular disease risk <15 percent), treat to a blood pressure target of <140/90 mmHg (Level of evidence: A)

Guidance (Usage) In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an emergency department (ED) visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed "not controlled". If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS165v13. 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).
Measure Group (Rate) (ID: 650b4f94da013638e7b3dd9a)
Basis boolean
Scoring Proportion
Improvement Notation increase
Type Outcome
Rate Aggregation None
Initial Population ID: DB8494F3-F2F2-4493-A9F6-8793D5F77F41
Description:

Patients 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period

Criteria: Initial Population
Denominator ID: 47151B22-36FA-413F-8F3A-665071CB2E83
Description:

Equals Initial Population

Criteria: Denominator
Denominator Exclusion ID: cc61a60b-d556-4368-9651-a1577003ae68
Description:

Exclude patients who are in hospice care for any part of the measurement period. Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period. Exclude patients 66-80 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 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period. 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: Denominator Exclusions
Numerator ID: D4F113F9-F280-45AC-ACDA-88CD87C42EB6
Description:

Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period

Criteria: Numerator
Stratifier ID: 863b910a-a4b5-4493-8e8e-3c94a4560d7b
Stratifier ID: 33cce73e-b08d-4304-b3c6-f25eb0da594b
Supplemental Data Elements
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: SDE Sex
Logic Definition: SDE Sex
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: SDE Race
Logic Definition: SDE Race
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: SDE Payer
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: SDE Ethnicity
Logic Definition: SDE Ethnicity
Measure Logic
Primary Library Controlling High Blood Pressure FHIR
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Parameters
Population Criteria
Measure Group (Rate) (ID: 650b4f94da013638e7b3dd9a)
Initial Population
define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[18, 85]
    and exists "Essential Hypertension Diagnosis"
    and exists AdultOutpatientEncounters."Qualifying Encounters"
Definition
Denominator
define "Denominator":
  "Initial Population"
Definition
Denominator Exclusion
define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy or Renal Diagnosis" )
    or exists ( "End Stage Renal Disease Procedures" )
    or exists ( "End Stage Renal Disease Encounter" )
    or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty"
    or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
Definition
Numerator
define "Numerator":
  "Has Systolic Blood Pressure Less Than 140"
    and "Has Diastolic Blood Pressure Less Than 90"
Definition
Logic Definitions
Logic Definition Library Name: AdultOutpatientEncounters
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"
Logic Definition Library Name: Hospice
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"
    )
Logic Definition Library Name: AdvancedIllnessandFrailty
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"
    )
Logic Definition Library Name: AdvancedIllnessandFrailty
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"])
Logic Definition Library Name: AdvancedIllnessandFrailty
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
  )
Logic Definition Library Name: AdvancedIllnessandFrailty
define "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty":
  ( AgeInYearsAt(date from end of "Measurement Period")in Interval[66, 80]
      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"
      )
  )
    or ( AgeInYearsAt(date from end of "Measurement Period")>= 81
        and "Has Criteria Indicating Frailty"
    )
Logic Definition Library Name: AdvancedIllnessandFrailty
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
Logic Definition Library Name: PalliativeCare
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"
    )
Logic Definition Library Name: SupplementalDataElements
define "SDE Sex":
  case
    when Patient.gender = 'male' then "M"
    when Patient.gender = 'female' then "F"
    else null
  end
Logic Definition Library Name: SupplementalDataElements
define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }
Logic Definition Library Name: SupplementalDataElements
define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }
Logic Definition Library Name: SupplementalDataElements
define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "SDE Sex":
  SDE."SDE Sex"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Qualifying Systolic Blood Pressure Reading":
  ( ( ["observation-bp"] ).isObservationBP ( ) ) BloodPressure
    where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) )
      and BloodPressure.effective.latest ( ) during day of "Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Qualifying Diastolic Blood Pressure Reading":
  ( ( ["observation-bp"] ).isObservationBP ( ) ) BloodPressure
    where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) )
      and BloodPressure.effective.latest ( ) during day of "Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Blood Pressure Days":
  ( "Qualifying Diastolic Blood Pressure Reading" DBPExam
      return date from DBPExam.effective.latest ( )
  )
    intersect ( "Qualifying Systolic Blood Pressure Reading" SBPExam
        return date from SBPExam.effective.latest ( )
    )
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Most Recent Blood Pressure Day":
  Last("Blood Pressure Days" BPDays
      sort asc
  )
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Lowest Systolic Reading on Most Recent Blood Pressure Day":
  First("Qualifying Systolic Blood Pressure Reading" SBPReading
      where SBPReading.effective.latest() same day as "Most Recent Blood Pressure Day"
      return singleton from(SBPReading.component SBPComponent
          where SBPComponent.code ~ "Systolic blood pressure"
          return SBPComponent.value as Quantity
      )
      sort asc
  )
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Has Systolic Blood Pressure Less Than 140":
  "Lowest Systolic Reading on Most Recent Blood Pressure Day" < 140 'mm[Hg]'
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Lowest Diastolic Reading on Most Recent Blood Pressure Day":
  First("Qualifying Diastolic Blood Pressure Reading" DBPReading
      where DBPReading.effective.latest() same day as "Most Recent Blood Pressure Day"
      return singleton from(DBPReading.component DBPComponent
          where DBPComponent.code ~ "Diastolic blood pressure"
          return DBPComponent.value as Quantity
      )
      sort asc
  )
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Has Diastolic Blood Pressure Less Than 90":
  "Lowest Diastolic Reading on Most Recent Blood Pressure Day" < 90 'mm[Hg]'
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Numerator":
  "Has Systolic Blood Pressure Less Than 140"
    and "Has Diastolic Blood Pressure Less Than 90"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Essential Hypertension Diagnosis":
  ( [Condition: "Essential Hypertension"] ) Hypertension
    where Hypertension.prevalenceInterval ( ) overlaps Interval[start of "Measurement Period", start of "Measurement Period" + 6 months )
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[18, 85]
    and exists "Essential Hypertension Diagnosis"
    and exists AdultOutpatientEncounters."Qualifying Encounters"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Denominator":
  "Initial Population"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "SDE Payer":
  SDE."SDE Payer"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "SDE Ethnicity":
  SDE."SDE Ethnicity"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Pregnancy or Renal Diagnosis":
  ( [Condition: "Pregnancy"]
    union [Condition: "End Stage Renal Disease"]
    union [Condition: "Kidney Transplant Recipient"]
    union [Condition: "Chronic Kidney Disease, Stage 5"] ) PregnancyESRDDiagnosis
    where PregnancyESRDDiagnosis.prevalenceInterval ( ) overlaps "Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "End Stage Renal Disease Procedures":
  ( ( [Procedure: "Kidney Transplant"]
      union [Procedure: "Dialysis Services"]
  ).isProcedurePerformed ( ) ) ESRDProcedure
    where ESRDProcedure.performed.toInterval ( ) ends on or before end of "Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "End Stage Renal Disease Encounter":
  ( ( [Encounter: "ESRD Monthly Outpatient Services"] ).isEncounterPerformed ( ) ) ESRDEncounter
    where ESRDEncounter.period.toInterval ( ) starts on or before end of "Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy or Renal Diagnosis" )
    or exists ( "End Stage Renal Disease Procedures" )
    or exists ( "End Stage Renal Disease Encounter" )
    or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty"
    or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define "SDE Race":
  SDE."SDE Race"
Logic Definition Library Name: ControllingHighBloodPressureFHIR
define fluent function getEncounter(reference Reference):
  singleton from ( [Encounter] E
      where E.id = reference.reference.getId ( )
  )
Logic Definition Library Name: FHIRHelpers
/*
@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]
Logic Definition Library Name: FHIRHelpers
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers
/*
@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
        }
Logic Definition Library Name: FHIRHelpers
/*
@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
        }
Logic Definition Library Name: QICoreCommon
/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
  Last(Split(uri, '/'))
Logic Definition Library Name: QICoreCommon
/*
@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]
Logic Definition Library Name: QICoreCommon
/*
@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>
Logic Definition Library Name: QICoreCommon
/*
@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 toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval<DateTime> then
  		choice as Interval<DateTime>
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval<Quantity> then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
		else
			null as Interval<DateTime>
	end
Logic Definition Library Name: QICoreCommon
/*
@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
  )
Logic Definition Library Name: Status
//Observation Vital Signs
define fluent function isObservationBP(Obs List<"QICore.observation-bp">):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: Status
//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'}
Logic Definition Library Name: Status
//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"
      )
Logic Definition Library Name: Status
//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'
Logic Definition Library Name: Status
//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
  Proc P
    where P.status ~ 'completed'
Logic Definition Library Name: Status
//Procedure, Performed
define fluent function isProcedurePerformed(Proc List<Procedure>):
  Proc P
    where P.status ~ 'completed'
Logic Definition Library Name: Status
//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'
Logic Definition Library Name: Status
//Symptom
define fluent function isSymptom(Obs List<Observation>):
  Obs O
    where O.status in { 'preliminary', 'final', 'amended', 'corrected' }
Logic Definition Library Name: Status
//Medication, Active
define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>):
  MedicationRequest M
    where M.status = 'active'
      and M.intent = 'order'
Logic Definition Library Name: CumulativeMedicationDuration
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
Logic Definition Library Name: CumulativeMedicationDuration
/**********************************************************************/
/* 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
Logic Definition Library Name: CumulativeMedicationDuration
/*
 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 * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
    when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
    else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
  end
Terminology
Code System Description: Code system AdministrativeGender
Resource: AdministrativeGender
Canonical URL: http://hl7.org/fhir/administrative-gender
Code System Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Code System Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Code System Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Code System Description: Code system ObservationCategoryCodes
Resource: Observation Category Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/observation-category
Value Set Description: Value set Essential Hypertension
Resource: Essential Hypertension
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.104.12.1011
Value Set 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
Value Set 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
Value Set 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
Value Set 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
Value Set 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
Value Set Description: Value set Virtual Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Value Set Description: Value set Telephone Visits
Resource: Telephone Visits
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Value Set Description: Value set Payer Type
Resource: Payer
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Value Set 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
Value Set Description: Value set Hospice Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Value Set Description: Value set Hospice Care Ambulatory
Resource: Hospice Care Ambulatory
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Value Set Description: Value set Hospice Diagnosis
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Value Set Description: Value set Pregnancy
Resource: Pregnancy
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
Value Set Description: Value set End Stage Renal Disease
Resource: End Stage Renal Disease
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353
Value Set Description: Value set Kidney Transplant Recipient
Resource: Kidney Transplant Recipient
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1029
Value Set Description: Value set Chronic Kidney Disease, Stage 5
Resource: Chronic Kidney Disease, Stage 5
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002
Value Set Description: Value set Kidney Transplant
Resource: Kidney Transplant
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1012
Value Set Description: Value set Dialysis Services
Resource: Dialysis Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1013
Value Set Description: Value set ESRD Monthly Outpatient Services
Resource: ESRD Monthly Outpatient Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1014
Value Set 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
Value Set 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
Value Set 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
Value Set 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
Value Set 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
Value Set 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
Value Set Description: Value set Palliative Care Diagnosis
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Value Set Description: Value set Palliative Care Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Value Set Description: Value set Palliative Care Intervention
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Direct Reference Code Display: Male
Code: M
System: http://hl7.org/fhir/administrative-gender
Direct Reference Code Display: Female
Code: F
System: http://hl7.org/fhir/administrative-gender
Direct Reference Code Display: Systolic blood pressure
Code: 8480-6
System: http://loinc.org
Direct Reference Code Display: Diastolic blood pressure
Code: 8462-4
System: http://loinc.org
Direct Reference Code Display: Active
Code: active
System: http://terminology.hl7.org/CodeSystem/condition-clinical
Direct Reference Code Display: Recurrence
Code: recurrence
System: http://terminology.hl7.org/CodeSystem/condition-clinical
Direct Reference Code Display: Relapse
Code: relapse
System: http://terminology.hl7.org/CodeSystem/condition-clinical
Direct Reference Code Display: Discharge to home for hospice care (procedure)
Code: 428361000124107
System: http://snomed.info/sct
Direct Reference Code Display: Discharge to healthcare facility for hospice care (procedure)
Code: 428371000124100
System: http://snomed.info/sct
Direct Reference Code Display: survey
Code: survey
System: http://terminology.hl7.org/CodeSystem/observation-category
Direct Reference Code Display: Yes (qualifier value)
Code: 373066001
System: http://snomed.info/sct
Direct Reference Code Display: Hospice care [Minimum Data Set]
Code: 45755-6
System: http://loinc.org
Direct Reference Code Display: Medical equipment used
Code: 98181-1
System: http://loinc.org
Direct Reference Code Display: Housing status
Code: 71802-3
System: http://loinc.org
Direct Reference Code Display: Lives in a nursing home (finding)
Code: 160734000
System: http://snomed.info/sct
Direct Reference Code Display: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
Code: 71007-9
System: http://loinc.org
Dependencies
Dependency Description: QICore model information
Resource: http://hl7.org/fhir/us/qicore/Library/QICore-ModelInfo|4.1.1
Canonical URL: http://hl7.org/fhir/us/qicore/Library/QICore-ModelInfo|4.1.1
Dependency Description: Library SDE
Resource: SupplementalDataElementsversion: null3.5.000)
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|3.5.000
Dependency Description: Library Status
Resource: Statusversion: null1.8.000)
Canonical URL: https://madie.cms.gov/Library/Status|1.8.000
Dependency Description: Library FHIRHelpers
Resource: FHIRHelpersversion: null4.4.000)
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library QICoreCommon
Resource: QICoreCommonversion: null2.1.000)
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|2.1.000
Dependency Description: Library AdultOutpatientEncounters
Resource: AdultOutpatientEncountersversion: null4.11.000)
Canonical URL: https://madie.cms.gov/Library/AdultOutpatientEncounters|4.11.000
Dependency Description: Library Hospice
Resource: Hospiceversion: null6.12.000)
Canonical URL: https://madie.cms.gov/Library/Hospice|6.12.000
Dependency Description: Library AIFrailLTCF
Resource: AdvancedIllnessandFrailtyversion: null1.16.000)
Canonical URL: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.16.000
Dependency Description: Library CMD
Resource: CumulativeMedicationDurationversion: null4.1.000)
Canonical URL: https://madie.cms.gov/Library/CumulativeMedicationDuration|4.1.000
Dependency Description: Library PalliativeCare
Resource: PalliativeCareversion: null1.11.000)
Canonical URL: https://madie.cms.gov/Library/PalliativeCare|1.11.000
Data Requirements
Data Requirement Type: Patient
Profile(s): QICorePatient
Must Support Elements: ethnicity, race
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: id, id.value, status, status.value, period
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Office Visit
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Annual Wellness Visit
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services - Established Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services-Initial Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Home Healthcare Services
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: Telephone Visits
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period, status, status.value
Code Filter(s):
Path: type
ValueSet: Encounter Inpatient
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: ESRD Monthly Outpatient Services
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: Frailty Encounter
Data Requirement Type: Encounter
Profile(s): QICoreEncounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Data Requirement Type: Observation
Profile(s): Observation Blood Pressure Profile
Must Support Elements: encounter, encounter.class, encounter.class.code, effective, status, status.value, component
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Essential Hypertension
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Pregnancy
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: End Stage Renal Disease
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Kidney Transplant Recipient
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Chronic Kidney Disease, Stage 5
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Frailty Diagnosis
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Advanced Illness
Data Requirement Type: Condition
Profile(s): QICoreCondition
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Data Requirement Type: Coverage
Profile(s): QICoreCoverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, value, effective, status, status.value, category
Code Filter(s):
Path: code
Code(s): LOINC: 45755-6 (Hospice care [Minimum Data Set])
Path: value
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, value, effective, status, status.value, category
Code Filter(s):
Path: code
Code(s): LOINC: 98181-1 (Medical equipment used)
Path: value
ValueSet: Frailty Device
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, effective, status, status.value, category
Code Filter(s):
Path: code
ValueSet: Frailty Symptom
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, effective, status, status.value, category
Code Filter(s):
Path: code
Code(s): LOINC: 71802-3 (Housing status)
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, effective, value, status, status.value, category
Code Filter(s):
Path: code
Code(s): LOINC: 71802-3 (Housing status)
Path: value
Data Requirement Type: Observation
Profile(s): QICoreObservation
Must Support Elements: code, effective, status, status.value, category
Code Filter(s):
Path: code
Code(s): LOINC: 71007-9 (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal))
Data Requirement Type: ServiceRequest
Profile(s): QICoreServiceRequest
Must Support Elements: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Procedure
Profile(s): QICoreProcedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Procedure
Profile(s): QICoreProcedure
Must Support Elements: code, status, status.value, performed
Code Filter(s):
Path: code
ValueSet: Kidney Transplant
Data Requirement Type: Procedure
Profile(s): QICoreProcedure
Must Support Elements: code, status, status.value, performed
Code Filter(s):
Path: code
ValueSet: Dialysis Services
Data Requirement Type: Procedure
Profile(s): QICoreProcedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Data Requirement Type: DeviceRequest
Profile(s): QICoreDeviceRequest
Must Support Elements: code, status, status.value, intent, intent.value, url, url.value, value, authoredOn, authoredOn.value
Code Filter(s):
Path: code
ValueSet: Frailty Device
Data Requirement Type: MedicationRequest
Profile(s): QICoreMedicationRequest
Must Support Elements: medication, status, status.value, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod
Code Filter(s):
Path: medication
ValueSet: Dementia Medications
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
ErrorLevel In 0..1 string
SDE Sex Out 0..1 Coding
Numerator Out 0..1 boolean
Denominator Out 0..1 boolean
SDE Payer Out 0..* Resource
Initial Population Out 0..1 boolean
SDE Ethnicity Out 0..1 Resource
Denominator Exclusions Out 0..1 boolean
SDE Race Out 0..1 Resource
Generated using version 0.5.4-cibuild of the sample-content-ig Liquid templates