Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build

Draft dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.1.0 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-2025/ and changes regularly. See the Directory of published versions

Library: Library

Official URL: https://madie.cms.gov/Measure/CMS122FHIRDiabetesAssessGT9Pct#effective-data-requirements Version: 1.1.000
Active Responsible: National Committee for Quality Assurance Computable Name: EffectiveDataRequirements
Metadata
Type module-definition from http://terminology.hl7.org/CodeSystem/library-type
Dependency Description: USQualityCore model information
Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Dependency Description: USCore model information
Resource: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived
Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived
Dependency Description: FHIR model information
Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
Dependency Description: Library SDE
Resource: SupplementalDataElementsversion: null6.1.000)
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Dependency Description: Library USCommon
Resource: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot
Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot
Dependency Description: Library FHIRCommon
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0
Dependency Description: Library Status
Resource: Statusversion: null2.1.000)
Canonical URL: https://madie.cms.gov/Library/Status|2.1.000
Dependency Description: Library Hospice
Resource: Hospiceversion: null7.1.000)
Canonical URL: https://madie.cms.gov/Library/Hospice|7.1.000
Dependency Description: Library AIFrailLTCF
Resource: AdvancedIllnessandFrailtyversion: null2.1.000)
Canonical URL: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|2.1.000
Dependency Description: Library CMD
Resource: http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot
Canonical URL: http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot
Dependency Description: Library PalliativeCare
Resource: PalliativeCareversion: null2.1.000)
Canonical URL: https://madie.cms.gov/Library/PalliativeCare|2.1.000
Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Dependency Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Code system CPT
Resource: Current Procedural Terminology (CPT®)
Canonical URL: http://www.ama-assn.org/go/cpt
Dependency Description: Code system HCPCS
Resource: Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes
Canonical URL: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
Dependency Description: Code system ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status
Dependency Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Dependency Description: Value set HbA1c Laboratory Test
Resource: HbA1c Laboratory Test
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013
Dependency 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
Dependency 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
Dependency 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
Dependency 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
Dependency 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
Dependency Description: Value set Nutrition Services
Resource: Nutrition Services
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006
Dependency 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
Dependency Description: Value set Diabetes
Resource: Diabetes
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
Dependency Description: Value set Payer Type
Resource: Payer Type
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Dependency 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
Dependency Description: Value set Hospice Encounter
Resource: Hospice Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Dependency 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
Dependency Description: Value set Hospice Diagnosis
Resource: Hospice Diagnosis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Dependency 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
Dependency 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
Dependency 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
Dependency 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
Dependency 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
Dependency 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
Dependency Description: Value set Palliative Care Diagnosis
Resource: Palliative Care Diagnosis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Dependency Description: Value set Palliative Care Encounter
Resource: Palliative Care Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Dependency Description: Value set Palliative Care Intervention
Resource: Palliative Care Intervention
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Data Requirement Type: Patient
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient
Must Support Elements: ombCategory, detailed, text
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: birthDate
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: code, status, effective, value
Code Filter(s):
Path: code
ValueSet: HbA1c Laboratory Test
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: code, status, effective, value
Code Filter(s):
Path: code
Code(s): LOINC: 97506-0 (Glucose management indicator)
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab
Must Support Elements: value, status, effective
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Office Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Annual Wellness Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Established Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Initial Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Home Healthcare Services
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Nutrition Services
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Telephone Visits
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: abatement, verificationStatus, onset, recordedDate, clinicalStatus
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, verificationStatus
Code Filter(s):
Path: code
ValueSet: Hospice Diagnosis
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, verificationStatus
Code Filter(s):
Path: code
ValueSet: Frailty Diagnosis
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, verificationStatus
Code Filter(s):
Path: code
ValueSet: Advanced Illness
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, verificationStatus
Code Filter(s):
Path: code
ValueSet: Palliative Care Diagnosis
Data Requirement Type: Condition
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Diabetes
Data Requirement Type: Coverage
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type
Data Requirement Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period
Code Filter(s):
Path: type
ValueSet: Encounter Inpatient
Data Requirement Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Hospice Encounter
Data Requirement Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Frailty Encounter
Data Requirement Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Palliative Care Encounter
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, value, effective, status
Code Filter(s):
Path: code
Code(s): LOINC: 45755-6 (Hospice care [Minimum Data Set])
Path: value
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, status
Code Filter(s):
Path: code
Code(s): LOINC: 71802-3 (Housing status)
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, value, status
Code Filter(s):
Path: code
Code(s): LOINC: 71802-3 (Housing status)
Path: value
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, value, effective, status
Code Filter(s):
Path: code
Code(s): LOINC: 98181-1 (Medical equipment used)
Path: value
ValueSet: Frailty Device
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Must Support Elements: code, effective, status
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): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest
Must Support Elements: code, authoredOn
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hospice Care Ambulatory
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Palliative Care Intervention
Data Requirement Type: DeviceRequest
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-devicerequest
Must Support Elements: code, authoredOn
Code Filter(s):
Path: code
ValueSet: Frailty Device
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation
Must Support Elements: code, effective, status
Code Filter(s):
Path: code
ValueSet: Frailty Symptom
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Code Filter(s):
Path: code
ValueSet: Dementia Medications
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication.reference, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, dispenseRequest.validityPeriod
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: medication, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, 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 of the sample-content-ig Liquid templates