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 |
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