Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build
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
| Draft as of 2026-09-19 |
<Library xmlns="http://hl7.org/fhir">
<id value="CMS157FHIRPainIntensityQuantified"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="metadata"> </a>Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">1.1.000</td>
</tr>
<tr>
<th scope="row" class="row-header">Status</th>
<td class="content-container">Draft</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">
<a href="http://terminology.hl7.org/7.1.0/CodeSystem-library-type.html">http://terminology.hl7.org/CodeSystem/library-type</a>#logic-library
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="parameters"> </a>Parameters</th>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">None</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Library Content</th>
</tr>
<tr>
<th scope="row" class="row-header">CQL Content</th>
<td>
<a name="cql-content"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
NOTE: For use by March 2026 US Realm Connectathon participants for internal use only. Not for use or distribution in commercial products.
*/
library CMS157FHIRPainIntensityQuantified version '1.1.000'
using USQualityCore version '0.1.0-cibuild'
using USCore version '6.1.0-derived'
using FHIR version '4.0.1'
include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers
include hl7.fhir.uv.cql.FHIRCommon version '2.0.0' called FHIRCommon
include hl7.fhir.us.cql.USCoreCommon version '2.0.0-ballot' called USCoreCommon
include hl7.fhir.us.cql.USCoreElements version '2.0.0-ballot' called USCoreElements
include CQMCommon version '5.1.000' called CQMCommon
include USQualityCoreCommon version '0.1.0-cibuild' called USQualityCoreCommon
include SupplementalDataElements version '6.1.000' called SDE
include Status version '2.1.000' called Status
codesystem "CPT": 'http://www.ama-assn.org/go/cpt'
valueset "Audio Visual Telehealth Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.1444.5.215'
valueset "Cancer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1010'
valueset "Chemotherapy Administration": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1027'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Radiation Treatment Management": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1026'
valueset "Standardized Pain Assessment Tool": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1028'
code "Radiation treatment management, 5 treatments": '77427' from "CPT" display 'Radiation treatment management, 5 treatments'
parameter "Measurement Period" Interval<DateTime>
default Interval[@2026-01-01T00:00:00.000Z, @2027-01-01T00:00:00.000Z)
context Patient
define "Denominator 1":
"Initial Population 1"
define "Denominator 2":
"Initial Population 2"
define "Initial Population 1":
"Face to Face or Telehealth Encounter with Ongoing Chemotherapy"
define "Initial Population 2":
"Radiation Treatment Management During Measurement Period with Cancer Diagnosis"
define "Chemotherapy Within 31 Days Prior and During Measurement Period":
[Procedure: "Chemotherapy Administration"] ChemoAdministration
where ChemoAdministration.performed.toInterval ( ) during Interval[start of "Measurement Period" - 31 days, end of "Measurement Period"]
and ChemoAdministration.status in { 'completed', 'in-progress' }
define "Face to Face or Telehealth Encounter with Ongoing Chemotherapy":
from
( [Encounter: "Office Visit"]
union [Encounter: "Audio Visual Telehealth Encounter"] ) FaceToFaceOrTelehealthEncounter,
"Chemotherapy Within 31 Days Prior and During Measurement Period" ChemoBeforeEncounter,
"Chemotherapy Within 31 Days Prior and During Measurement Period" ChemoAfterEncounter,
// [E-13] base FHIR.Condition retrieve (defect-tracking/engine-issues.md E-13)
// Original:
// ( [ConditionProblemsHealthConcerns: "Cancer"]
// union [ConditionEncounterDiagnosis: "Cancer"] ) CancerDx
[Condition: "Cancer"] CancerDx
where CancerDx.prevalenceInterval ( ) overlaps day of FaceToFaceOrTelehealthEncounter.period
and ChemoBeforeEncounter.performed.toInterval ( ) starts 30 days or less on or before day of end of FaceToFaceOrTelehealthEncounter.period
and ChemoAfterEncounter.performed.toInterval ( ) starts 30 days or less on or after day of end of FaceToFaceOrTelehealthEncounter.period
and not ( ChemoAfterEncounter.performed.toInterval ( ) same day as ChemoBeforeEncounter.performed.toInterval ( ) )
and FaceToFaceOrTelehealthEncounter.period during day of "Measurement Period"
and FaceToFaceOrTelehealthEncounter.status = 'finished'
return FaceToFaceOrTelehealthEncounter
define "Numerator 1":
"Face to Face or Telehealth Encounter with Ongoing Chemotherapy" FaceToFaceOrTelehealthEncounterWithChemo
with "Standard Pain Assessment with Result" PainAssessed
such that PainAssessed.effective.toInterval ( ) during day of FaceToFaceOrTelehealthEncounterWithChemo.period
define "Radiation Treatment Management During Measurement Period with Cancer Diagnosis":
( [Encounter: "Radiation Treatment Management"] ) RadiationTreatmentManagement
// [E-13] base FHIR.Condition retrieve (defect-tracking/engine-issues.md E-13)
// Original:
// with ( [ConditionProblemsHealthConcerns: "Cancer"]
// union [ConditionEncounterDiagnosis: "Cancer"] ) CancerDx
with [Condition: "Cancer"] CancerDx
such that CancerDx.prevalenceInterval ( ) overlaps day of RadiationTreatmentManagement.period
where RadiationTreatmentManagement.period during day of "Measurement Period"
and RadiationTreatmentManagement.status = 'finished'
define "Numerator 2":
"Radiation Treatment Management During Measurement Period with Cancer Diagnosis" RadiationManagementEncounter
with "Standard Pain Assessment with Result" PainAssessed
such that case
when exists ( ( RadiationManagementEncounter.type ) RadiationManagement
where RadiationManagement ~ "Radiation treatment management, 5 treatments"
) then PainAssessed.effective.toInterval ( ) 6 days or less on or before day of start of RadiationManagementEncounter.period
else PainAssessed.effective.toInterval ( ) during day of RadiationManagementEncounter.period end
define "SDE Ethnicity":
SDE."SDE Ethnicity"
define "SDE Payer":
SDE."SDE Payer"
define "SDE Race":
SDE."SDE Race"
define "SDE Sex":
SDE."SDE Sex"
define "Standard Pain Assessment with Result":
[ObservationScreeningAssessment: "Standardized Pain Assessment Tool"] AssessedPain
where AssessedPain.value is not null</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.5.6 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url
value="https://madie.cms.gov/Library/CMS157FHIRPainIntensityQuantified"/>
<version value="1.1.000"/>
<name value="CMS157FHIRPainIntensityQuantified"/>
<status value="draft"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="logic-library"/>
</coding>
</type>
<date value="2026-09-19T16:31:14+00:00"/>
<content>
<contentType value="text/cql"/>
<data
value="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<url
value="https://madie.cms.gov/Library-CMS157FHIRPainIntensityQuantified.cql"/>
</content>
</Library>