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

: CMS819FHIRHHORAE - XML Representation

Draft as of 2026-09-19

Raw xml | Download


<Library xmlns="http://hl7.org/fhir">
  <id value="CMS819FHIRHHORAE"/>
  <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 CMS819FHIRHHORAE 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 &quot;SNOMEDCT&quot;: 'http://snomed.info/sct'

valueset &quot;Encounter Inpatient&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset &quot;Operating Room Suite&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.141'
valueset &quot;Opioid Antagonist&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.119'
valueset &quot;Opioids, All&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1196.226'
valueset &quot;Routes of Administration for Opioid Antagonists&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.187'

parameter &quot;Measurement Period&quot; Interval&lt;DateTime&gt;
  default Interval[@2026-01-01T00:00:00.000Z, @2027-01-01T00:00:00.000Z)

context Patient

define &quot;Denominator&quot;:
  &quot;Initial Population&quot;

define &quot;Initial Population&quot;:
  &quot;Encounter With Opioid Administration Outside Of Operating Room&quot;

define &quot;Numerator&quot;:
  &quot;Encounter With NonOperating Room Opioid And Antagonist Administration&quot;

define &quot;Opioid Administration&quot;:
  [&quot;MedicationAdministration&quot;: &quot;Opioids, All&quot;] Opioids
    where Opioids.status = 'completed'

define &quot;Non Enteral Opioid Antagonist Administration&quot;:
  [&quot;MedicationAdministration&quot;: &quot;Opioid Antagonist&quot;] AntagonistGiven
    where AntagonistGiven.status = 'completed'

define &quot;Qualifying Encounter&quot;:
  [&quot;Encounter&quot;: &quot;Encounter Inpatient&quot;] InpatientEncounter
    where AgeInYearsAt(date from start of InpatientEncounter.period) &gt;= 18
      and InpatientEncounter.period ends during day of &quot;Measurement Period&quot;
      and InpatientEncounter.status = 'finished'

define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;

define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;

define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;

define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;

define &quot;Encounter With Opioid Administration Outside Of Operating Room&quot;:
  &quot;Qualifying Encounter&quot; InpatientEncounter
    with &quot;Opioid Administration&quot; OpioidGiven
      such that OpioidGiven.effective.toInterval ( ) starts during InpatientEncounter.hospitalizationWithObservation ( )
        and not exists ( InpatientEncounter.location EncounterLocation
            where EncounterLocation.location.getLocation ( ).type in &quot;Operating Room Suite&quot;
              and OpioidGiven.effective.toInterval ( ) starts during EncounterLocation.period
        )


 /*
@author: Measure developer
@description: Provides guidance to implementers to interpret logic in following defintion correctly
@comment:Excludes opioid antagonist administered in operating room AND excludes opioids administered in operating room AND opioid is administered before opioid antagonist AND limits opioid antagonist to non-enteral routes
 */


define &quot;Encounter With NonOperating Room Opioid And Antagonist Administration&quot;:
  from
    &quot;Non Enteral Opioid Antagonist Administration&quot; NonEnteralOpioidAntagonistGiven,
    &quot;Opioid Administration&quot; OpioidGiven,
    &quot;Denominator&quot; InpatientHospitalization
    where not exists ( InpatientHospitalization.location EncounterLocation
        where EncounterLocation.location.getLocation ( ).type in &quot;Operating Room Suite&quot;
          and NonEnteralOpioidAntagonistGiven.effective.toInterval ( ) starts during EncounterLocation.period
    )
      and ( NonEnteralOpioidAntagonistGiven.effective.toInterval ( ) starts during InpatientHospitalization.hospitalizationWithObservation ( )
          and OpioidGiven.effective.toInterval ( ) starts during InpatientHospitalization.hospitalizationWithObservation ( )
          and OpioidGiven.effective.toInterval ( ) ends 12 hours or less before start of NonEnteralOpioidAntagonistGiven.effective.toInterval ( )
          and NonEnteralOpioidAntagonistGiven.dosage.route in &quot;Routes of Administration for Opioid Antagonists&quot;
      )
    return InpatientHospitalization</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/CMS819FHIRHHORAE"/>
  <version value="1.1.000"/>
  <name value="CMS819FHIRHHORAE"/>
  <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="LyoKTk9URTogRm9yIHVzZSBieSBNYXJjaCAyMDI2IFVTIFJlYWxtIENvbm5lY3RhdGhvbiBwYXJ0aWNpcGFudHMgZm9yIGludGVybmFsIHVzZSBvbmx5LiBOb3QgZm9yIHVzZSBvciBkaXN0cmlidXRpb24gaW4gY29tbWVyY2lhbCBwcm9kdWN0cy4KKi8KbGlicmFyeSBDTVM4MTlGSElSSEhPUkFFIHZlcnNpb24gJzEuMS4wMDAnCgp1c2luZyBVU1F1YWxpdHlDb3JlIHZlcnNpb24gJzAuMS4wLWNpYnVpbGQnCnVzaW5nIFVTQ29yZSB2ZXJzaW9uICc2LjEuMC1kZXJpdmVkJwp1c2luZyBGSElSIHZlcnNpb24gJzQuMC4xJwoKaW5jbHVkZSBobDcuZmhpci51di5jcWwuRkhJUkhlbHBlcnMgdmVyc2lvbiAnNC4wLjEnIGNhbGxlZCBGSElSSGVscGVycwppbmNsdWRlIGhsNy5maGlyLnV2LmNxbC5GSElSQ29tbW9uIHZlcnNpb24gJzIuMC4wJyBjYWxsZWQgRkhJUkNvbW1vbgppbmNsdWRlIGhsNy5maGlyLnVzLmNxbC5VU0NvcmVDb21tb24gdmVyc2lvbiAnMi4wLjAtYmFsbG90JyBjYWxsZWQgVVNDb3JlQ29tbW9uCmluY2x1ZGUgaGw3LmZoaXIudXMuY3FsLlVTQ29yZUVsZW1lbnRzIHZlcnNpb24gJzIuMC4wLWJhbGxvdCcgY2FsbGVkIFVTQ29yZUVsZW1lbnRzCgppbmNsdWRlIENRTUNvbW1vbiB2ZXJzaW9uICc1LjEuMDAwJyBjYWxsZWQgQ1FNQ29tbW9uCmluY2x1ZGUgVVNRdWFsaXR5Q29yZUNvbW1vbiB2ZXJzaW9uICcwLjEuMC1jaWJ1aWxkJyBjYWxsZWQgVVNRdWFsaXR5Q29yZUNvbW1vbgppbmNsdWRlIFN1cHBsZW1lbnRhbERhdGFFbGVtZW50cyB2ZXJzaW9uICc2LjEuMDAwJyBjYWxsZWQgU0RFCmluY2x1ZGUgU3RhdHVzIHZlcnNpb24gJzIuMS4wMDAnIGNhbGxlZCBTdGF0dXMKCmNvZGVzeXN0ZW0gIlNOT01FRENUIjogJ2h0dHA6Ly9zbm9tZWQuaW5mby9zY3QnCgp2YWx1ZXNldCAiRW5jb3VudGVyIElucGF0aWVudCI6ICdodHRwOi8vY3RzLm5sbS5uaWguZ292L2ZoaXIvVmFsdWVTZXQvMi4xNi44NDAuMS4xMTM4ODMuMy42NjYuNS4zMDcnCnZhbHVlc2V0ICJPcGVyYXRpbmcgUm9vbSBTdWl0ZSI6ICdodHRwOi8vY3RzLm5sbS5uaWguZ292L2ZoaXIvVmFsdWVTZXQvMi4xNi44NDAuMS4xMTM3NjIuMS40LjEyNDguMTQxJwp2YWx1ZXNldCAiT3Bpb2lkIEFudGFnb25pc3QiOiAnaHR0cDovL2N0cy5ubG0ubmloLmdvdi9maGlyL1ZhbHVlU2V0LzIuMTYuODQwLjEuMTEzNzYyLjEuNC4xMjQ4LjExOScKdmFsdWVzZXQgIk9waW9pZHMsIEFsbCI6ICdodHRwOi8vY3RzLm5sbS5uaWguZ292L2ZoaXIvVmFsdWVTZXQvMi4xNi44NDAuMS4xMTM3NjIuMS40LjExOTYuMjI2Jwp2YWx1ZXNldCAiUm91dGVzIG9mIEFkbWluaXN0cmF0aW9uIGZvciBPcGlvaWQgQW50YWdvbmlzdHMiOiAnaHR0cDovL2N0cy5ubG0ubmloLmdvdi9maGlyL1ZhbHVlU2V0LzIuMTYuODQwLjEuMTEzNzYyLjEuNC4xMjQ4LjE4NycKCnBhcmFtZXRlciAiTWVhc3VyZW1lbnQgUGVyaW9kIiBJbnRlcnZhbDxEYXRlVGltZT4KICBkZWZhdWx0IEludGVydmFsW0AyMDI2LTAxLTAxVDAwOjAwOjAwLjAwMFosIEAyMDI3LTAxLTAxVDAwOjAwOjAwLjAwMFopCgpjb250ZXh0IFBhdGllbnQKCmRlZmluZSAiRGVub21pbmF0b3IiOgogICJJbml0aWFsIFBvcHVsYXRpb24iCgpkZWZpbmUgIkluaXRpYWwgUG9wdWxhdGlvbiI6CiAgIkVuY291bnRlciBXaXRoIE9waW9pZCBBZG1pbmlzdHJhdGlvbiBPdXRzaWRlIE9mIE9wZXJhdGluZyBSb29tIgoKZGVmaW5lICJOdW1lcmF0b3IiOgogICJFbmNvdW50ZXIgV2l0aCBOb25PcGVyYXRpbmcgUm9vbSBPcGlvaWQgQW5kIEFudGFnb25pc3QgQWRtaW5pc3RyYXRpb24iCgpkZWZpbmUgIk9waW9pZCBBZG1pbmlzdHJhdGlvbiI6CiAgWyJNZWRpY2F0aW9uQWRtaW5pc3RyYXRpb24iOiAiT3Bpb2lkcywgQWxsIl0gT3Bpb2lkcwogICAgd2hlcmUgT3Bpb2lkcy5zdGF0dXMgPSAnY29tcGxldGVkJwoKZGVmaW5lICJOb24gRW50ZXJhbCBPcGlvaWQgQW50YWdvbmlzdCBBZG1pbmlzdHJhdGlvbiI6CiAgWyJNZWRpY2F0aW9uQWRtaW5pc3RyYXRpb24iOiAiT3Bpb2lkIEFudGFnb25pc3QiXSBBbnRhZ29uaXN0R2l2ZW4KICAgIHdoZXJlIEFudGFnb25pc3RHaXZlbi5zdGF0dXMgPSAnY29tcGxldGVkJwoKZGVmaW5lICJRdWFsaWZ5aW5nIEVuY291bnRlciI6CiAgWyJFbmNvdW50ZXIiOiAiRW5jb3VudGVyIElucGF0aWVudCJdIElucGF0aWVudEVuY291bnRlcgogICAgd2hlcmUgQWdlSW5ZZWFyc0F0KGRhdGUgZnJvbSBzdGFydCBvZiBJbnBhdGllbnRFbmNvdW50ZXIucGVyaW9kKSA+PSAxOAogICAgICBhbmQgSW5wYXRpZW50RW5jb3VudGVyLnBlcmlvZCBlbmRzIGR1cmluZyBkYXkgb2YgIk1lYXN1cmVtZW50IFBlcmlvZCIKICAgICAgYW5kIElucGF0aWVudEVuY291bnRlci5zdGF0dXMgPSAnZmluaXNoZWQnCgpkZWZpbmUgIlNERSBFdGhuaWNpdHkiOgogIFNERS4iU0RFIEV0aG5pY2l0eSIKCmRlZmluZSAiU0RFIFBheWVyIjoKICBTREUuIlNERSBQYXllciIKCmRlZmluZSAiU0RFIFJhY2UiOgogIFNERS4iU0RFIFJhY2UiCgpkZWZpbmUgIlNERSBTZXgiOgogIFNERS4iU0RFIFNleCIKCmRlZmluZSAiRW5jb3VudGVyIFdpdGggT3Bpb2lkIEFkbWluaXN0cmF0aW9uIE91dHNpZGUgT2YgT3BlcmF0aW5nIFJvb20iOgogICJRdWFsaWZ5aW5nIEVuY291bnRlciIgSW5wYXRpZW50RW5jb3VudGVyCiAgICB3aXRoICJPcGlvaWQgQWRtaW5pc3RyYXRpb24iIE9waW9pZEdpdmVuCiAgICAgIHN1Y2ggdGhhdCBPcGlvaWRHaXZlbi5lZmZlY3RpdmUudG9JbnRlcnZhbCAoICkgc3RhcnRzIGR1cmluZyBJbnBhdGllbnRFbmNvdW50ZXIuaG9zcGl0YWxpemF0aW9uV2l0aE9ic2VydmF0aW9uICggKQogICAgICAgIGFuZCBub3QgZXhpc3RzICggSW5wYXRpZW50RW5jb3VudGVyLmxvY2F0aW9uIEVuY291bnRlckxvY2F0aW9uCiAgICAgICAgICAgIHdoZXJlIEVuY291bnRlckxvY2F0aW9uLmxvY2F0aW9uLmdldExvY2F0aW9uICggKS50eXBlIGluICJPcGVyYXRpbmcgUm9vbSBTdWl0ZSIKICAgICAgICAgICAgICBhbmQgT3Bpb2lkR2l2ZW4uZWZmZWN0aXZlLnRvSW50ZXJ2YWwgKCApIHN0YXJ0cyBkdXJpbmcgRW5jb3VudGVyTG9jYXRpb24ucGVyaW9kCiAgICAgICAgKQoKCiAvKgpAYXV0aG9yOiBNZWFzdXJlIGRldmVsb3BlcgpAZGVzY3JpcHRpb246IFByb3ZpZGVzIGd1aWRhbmNlIHRvIGltcGxlbWVudGVycyB0byBpbnRlcnByZXQgbG9naWMgaW4gZm9sbG93aW5nIGRlZmludGlvbiBjb3JyZWN0bHkKQGNvbW1lbnQ6RXhjbHVkZXMgb3Bpb2lkIGFudGFnb25pc3QgYWRtaW5pc3RlcmVkIGluIG9wZXJhdGluZyByb29tIEFORCBleGNsdWRlcyBvcGlvaWRzIGFkbWluaXN0ZXJlZCBpbiBvcGVyYXRpbmcgcm9vbSBBTkQgb3Bpb2lkIGlzIGFkbWluaXN0ZXJlZCBiZWZvcmUgb3Bpb2lkIGFudGFnb25pc3QgQU5EIGxpbWl0cyBvcGlvaWQgYW50YWdvbmlzdCB0byBub24tZW50ZXJhbCByb3V0ZXMKICovCgoKZGVmaW5lICJFbmNvdW50ZXIgV2l0aCBOb25PcGVyYXRpbmcgUm9vbSBPcGlvaWQgQW5kIEFudGFnb25pc3QgQWRtaW5pc3RyYXRpb24iOgogIGZyb20KICAgICJOb24gRW50ZXJhbCBPcGlvaWQgQW50YWdvbmlzdCBBZG1pbmlzdHJhdGlvbiIgTm9uRW50ZXJhbE9waW9pZEFudGFnb25pc3RHaXZlbiwKICAgICJPcGlvaWQgQWRtaW5pc3RyYXRpb24iIE9waW9pZEdpdmVuLAogICAgIkRlbm9taW5hdG9yIiBJbnBhdGllbnRIb3NwaXRhbGl6YXRpb24KICAgIHdoZXJlIG5vdCBleGlzdHMgKCBJbnBhdGllbnRIb3NwaXRhbGl6YXRpb24ubG9jYXRpb24gRW5jb3VudGVyTG9jYXRpb24KICAgICAgICB3aGVyZSBFbmNvdW50ZXJMb2NhdGlvbi5sb2NhdGlvbi5nZXRMb2NhdGlvbiAoICkudHlwZSBpbiAiT3BlcmF0aW5nIFJvb20gU3VpdGUiCiAgICAgICAgICBhbmQgTm9uRW50ZXJhbE9waW9pZEFudGFnb25pc3RHaXZlbi5lZmZlY3RpdmUudG9JbnRlcnZhbCAoICkgc3RhcnRzIGR1cmluZyBFbmNvdW50ZXJMb2NhdGlvbi5wZXJpb2QKICAgICkKICAgICAgYW5kICggTm9uRW50ZXJhbE9waW9pZEFudGFnb25pc3RHaXZlbi5lZmZlY3RpdmUudG9JbnRlcnZhbCAoICkgc3RhcnRzIGR1cmluZyBJbnBhdGllbnRIb3NwaXRhbGl6YXRpb24uaG9zcGl0YWxpemF0aW9uV2l0aE9ic2VydmF0aW9uICggKQogICAgICAgICAgYW5kIE9waW9pZEdpdmVuLmVmZmVjdGl2ZS50b0ludGVydmFsICggKSBzdGFydHMgZHVyaW5nIElucGF0aWVudEhvc3BpdGFsaXphdGlvbi5ob3NwaXRhbGl6YXRpb25XaXRoT2JzZXJ2YXRpb24gKCApCiAgICAgICAgICBhbmQgT3Bpb2lkR2l2ZW4uZWZmZWN0aXZlLnRvSW50ZXJ2YWwgKCApIGVuZHMgMTIgaG91cnMgb3IgbGVzcyBiZWZvcmUgc3RhcnQgb2YgTm9uRW50ZXJhbE9waW9pZEFudGFnb25pc3RHaXZlbi5lZmZlY3RpdmUudG9JbnRlcnZhbCAoICkKICAgICAgICAgIGFuZCBOb25FbnRlcmFsT3Bpb2lkQW50YWdvbmlzdEdpdmVuLmRvc2FnZS5yb3V0ZSBpbiAiUm91dGVzIG9mIEFkbWluaXN0cmF0aW9uIGZvciBPcGlvaWQgQW50YWdvbmlzdHMiCiAgICAgICkKICAgIHJldHVybiBJbnBhdGllbnRIb3NwaXRhbGl6YXRpb24="/>
    <url value="https://madie.cms.gov/Library-CMS819FHIRHHORAE.cql"/>
  </content>
</Library>