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

## : Preventive Care and Screening: Screening for Depression and Follow-Up PlanFHIR - JSON Representation

Active as of 2026-01-16

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      "resourceType" : "Measure",
      "id" : "CMS2FHIRPCSDepScreenAndFollowUp",
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        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">Preventive Care and Screening: Screening for Depression and Follow-Up PlanFHIR\n</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">1.1.000</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n\n<td class=\"content-container\">CMS2FHIR</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:deb30835-dbec-4f11-aab0-3a282040e37c</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:fd005986-96a6-404d-896f-14257cf9611b</td>\n\n\n</tr>\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n\n<td class=\"content-container\">2FHIR</td>\n\n\n</tr>\n\n  \n\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n\n\n</tr>\n\n  \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n\n<td class=\"content-container\">Centers for Medicare &amp;amp; Medicaid Services (CMS)</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n\n<td class=\"content-container\">American Institutes for Research (AIR)</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n\n<td class=\"content-container\"><div><p>This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare &amp; Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications.</p>\n<p>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. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organization. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n\n<td class=\"content-container\"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.</p>\n<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n\n<td class=\"content-container\"><div><p>Depression affects more than two hundred sixty million people across the world and is a leading cause of disability, with a variety of depressive disorders that are independent risk factors for chronic diseases, such as cardiovascular disease and diabetes, lending screening for depression as paramount to identify depressive disorders that can affect the most vulnerable populations (Costantini et al., 2021). Results from a 2018 U.S. survey indicated that 14.4 percent of adolescents (3.5 million adolescents) had a major depressive episode (MDE) in the past year, with nine percent of adolescents (2.4 million adolescents) having one MDE with severe impairment (Substance Abuse and Mental Health Services Administration, 2019). The odds of a diagnosis of depression are believed to be 2.6 times greater for children and adolescents exposed to trauma as compared to those unexposed or less exposed (Vibhakar et al., 2019). Children and teens with major depressive disorder (MDD) have been found to have difficulty carrying out their daily activities, relating to others, growing up healthy, and are at an increased risk of suicide (Siu on behalf of the U.S. Preventive Services Task Force [USPSTF], 2016).</p>\n<p>The same 2018 study indicated that 7.2 percent of adults aged 18 or older (17.7 million adults) had at least one MDE with 4.7 percent of adults (11.5 million adults) having one MDE with severe impairment in the past year (Substance Abuse and Mental Health Services Administration, 2019). Moreover, it is estimated 22.9 percent of adult patients with chronic pain (2.2 million adults) were diagnosed with comorbid depression from 2011 to 2015, with an upward trend of prevalence among Black Americans, patients aged 65 to 84 years old, Medicare and Medicaid insured patients, and patients from zip code areas with low annual household incomes (Orhurhu et al., 2019).</p>\n<p>Depression and other mood disorders, such as bipolar disorder and anxiety disorders, especially during the perinatal period, can have devastating effects on women, infants, and families (American College of Obstetricians and Gynecologists, 2018). It's estimated that the global prevalence of antenatal (or perinatal) depression ranges from 15 to 65 percent, with current or previous exposure to abuse and violence, lack of social support, and family history of mental disorders being risk factors. Depressive symptoms measured during pregnancy have been shown to influence the quality of the postpartum mother-infant relationship (Hazell Raine et al., 2020). Additionally, the risk of low birth weight and preterm birth is higher among infants born from depressed mothers (Dadi, Miller, Bisetegn, &amp; Mwanri, 2020).</p>\n<p>Negative outcomes associated with depression make it crucial to screen in order to identify and treat depression in its early stages. Multiple social costs of depression have been identified, such as reduced educational achievements, poor financial success and role performance, higher amount of days out of role, and increased risk of job loss (Costantini et al., 2021). Depression also imposes significant economic burden through direct and indirect costs, supporting the need for regular depression screening. &quot;In the United States, an estimated $22.8 billion was spent on depression treatment in 2009, and lost productivity cost an additional estimated $23 billion in 2011&quot; (Siu &amp; USPSTF, 2016, p. 383-384).</p>\n<p>Numerous studies have found significant disparities in depression prevalence and treatment among racial/ethnic minorities. One study revealed that Indigenous adults are at a high risk for posttraumatic stress disorder, depression, suicide, substance use disorder, and concurrent behavioral health disorders secondary to these initial health problems (Ka'apu and Burnette, 2019). Additionally, though rates of depression are lower among Blacks and Hispanics than among whites, depression among Blacks and Hispanics is likely to be more recurrent. Furthermore, 48 percent of whites receive mental health services, compared to just 31 percent of Blacks and Hispanics, and 22 percent of Asians (American Psychiatric Association, 2017). Asian Americans and Black Americans are also significantly more likely to utilize emergency rooms for depression treatment, which contributes to inconsistent follow-up care (Lee et al., 2014).</p>\n<p>While primary care providers (PCPs) serve as the first line of defense in the detection of depression, studies show that PCPs fail to recognize up to 46 percent of depressed patients (Borner et al., 2010). &quot;In nationally representative U.S. surveys, about eight percent of adolescents reported having major depression in the past year. Only 36 percent to 44 percent of children and adolescents with depression receive treatment, suggesting that a majority of depressed youth are undiagnosed and untreated&quot; (Siu on behalf of USPSTF, 2016). Furthermore, evidence supports that screening for depression in pregnant and postpartum women is of moderate net benefit, and treatment options for positive depression screening should be available for patients twelve and older including pregnant and postpartum women.</p>\n<p>This measure seeks to align with USPSTF clinical guideline recommendations as well as the Healthy People 2030 recommendation to increase the proportion of adolescents and adults who are screened for depression and if positive, receive appropriate treatment (U.S. Preventive Services Task Force, 2016; U.S. Department of Health and Human Services, 2020).</p>\n<p>For patients with depression, rescreening has been shown to be an effective tool for measuring response to therapy, therefore influencing appropriate care adjustments in the treatment of depression (Anderson et al., 2002). Chen et al. noted that when patients were re-administered a screening tool after at least eight weeks after starting treatment, their &quot;score gave primary care physicians a clear idea about the nature of patients' depressive symptoms and gave both the patient and the physician an indication of treatment progress&quot; (Chen et al., 2006).</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n\n<td class=\"content-container\"><div><p>Adolescent Recommendation (12-18 years):</p>\n<p>&quot;The USPSTF recommends screening for MDD in adolescents aged 12 to 18 years. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up (B recommendation)&quot; (Siu on behalf of USPSTF, 2016).</p>\n<p>Adult Recommendation (18 years and older):</p>\n<p>&quot;The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up (B recommendation)&quot; (Siu &amp; USPSTF, 2016).</p>\n<p>&quot;The USPSTF recommends that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions (B recommendation)&quot; (U.S. Preventive Services Task Force, 2019).</p>\n<p>The American College of Obstetricians and Gynecologists (ACOG) provides the following recommendation: &quot;All obstetrician--gynecologists and other obstetric care providers should complete a full assessment of mood and emotional well-being (including screening for postpartum depression and anxiety with a validated instrument) during the comprehensive postpartum visit for each patient&quot; (American College of Obstetricians and Gynecologists, 2018).</p>\n<p>The Institute for Clinical Systems Improvement (ICSI) health care guideline, Adult Depression in Primary Care, provides the following recommendations:</p>\n<ol>\n<li>\n<p>&quot;Clinicians should routinely screen all adults for depression using a standardized instrument.&quot;</p>\n</li>\n<li>\n<p>&quot;Clinicians should establish and maintain follow-up with patients.&quot;</p>\n</li>\n<li>\n<p>&quot;Clinicians should screen and monitor depression in pregnant and post-partum women&quot; (Trangle et al., 2016).</p>\n</li>\n</ol>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. (2018). ACOG Committee Opinion Number 757: Screening for perinatal depression. Obstetrics and Gynecology, 132(5), e208-e212. doi: 10.1097/AOG.0000000000002927</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>American Psychiatric Association. (2017). Mental Health Disparities: Diverse Populations. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Anderson, J., Michalak, E., &amp; Lam, R. (2002). Depression in primary care: Tools for screening, diagnosis, and measuring response to treatment. BCMJ, 44(8),415-419. https://bcmj.org/articles/depression-primary-care-tools-screening-diagnosis-and-measuring-response-treatment</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Borner, I., Braunstein, J. W., St. Victor, R., &amp; Pollack, J. (2010). Evaluation of a 2-question screening tool for detecting depression in adolescents in primary care. Clinical Pediatrics, 49(10), 947-995. doi:10.1177/0009922810370203</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Chen, T., Huang, F., Chang, C., &amp; Chung, H. (2006), Using the PHQ-9 for depression screening and treatment monitoring for Chinese Americans in primary care. Psychiatr Serv., 57(7),976--981. https://ps.psychiatryonline.org/doi/full/10.1176/ps.2006.57.7.976</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Costantini, L., Costanza, A., Odone, A., Aguglia, A., Escelsior, A., Serafini, G., Amore, M., &amp; Amerio, A. (2021). A breakthrough in research on depression screening: from validation to efficacy studies. Acta bio-medica : Atenei Parmensis, 92(3), e2021215. https://doi.org/10.23750/abm.v92i3.11574</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Dadi, A. F., Miller, E. R., Bisetegn, T. A., &amp; Mwanri, L. (2020). Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC public health, 20(1), 173. https://doi.org/10.1186/s12889-020-8293-9</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Hazell Raine, K., Nath, S., Howard, L. M., Cockshaw, W., Boyce, P., Sawyer, E., &amp; Thorpe, K. (2020). Associations between prenatal maternal mental health indices and mother-infant relationship quality 6 to 18 months' postpartum: A systematic review. Infant mental health journal, 41(1), 24--39. https://doi.org/10.1002/imhj.21825</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Ka'apu, K., &amp; Burnette, C. E. (2019). A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?. British journal of social work, 49(4), 880--898. https://doi.org/10.1093/bjsw/bcz009</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Lee, S. Y., Xue, Q. L., Spira, A. P., &amp; Lee, H. B. (2014). Racial and ethnic differences in depressive subtypes and access to mental health care in the United States. Journal of affective disorders, 155, 130--137. https://doi.org/10.1016/j.jad.2013.10.037</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Orhurhu, V., Olusunmade, M., Akinola, Y., Urits, I., Orhurhu, M. S., Viswanath, O., ... Gill, J. S. (2019). Depression Trends in Patients with Chronic Pain: An Analysis of the Nationwide Inpatient Sample. Pain physician, 22(5), E487--E494.</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Siu, A. L., &amp; USPSTF. (2016). Screening for depression in adults: U.S. Preventive Services Task Force recommendation statement. Journal of the American Medical Association, 315(4), 380-387. doi:10.1001/jama.2015.18392.</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Siu, A. L., on behalf of USPSTF. (2016). Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 164(5), 360-366. doi:10.7326/M15-2957</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19 5068, NSDUH Series H 54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.htm#mde</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Trangle, M., Gursky, J., Haight, R., Hardwig, J., Hinnenkamp, T., Kessler, D.,... Myszkowski, M. (2016). Adult depression in primary care. Bloomington, MN: Institute for Clinical Systems Improvement. Retrieved from https://www.icsi.org/guideline/depression/</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>U.S. Department of Health and Human Services. (2020). Healthy People 2030: Depression in adults: Screening. Washington, DC: U.S. Department of Health and Human Services. Retrieved from https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/depression-adults-screening</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>U.S. Preventive Services Task Force. (2016). Final recommendation statement: depression in adults: screening. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/depression-in-adults-screening</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>U.S. Preventive Services Task Force. (2019). Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement. JAMA, 321(6):580--587. doi:10.1001/jama.2019.0007</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Vibhakar, V., Allen, L. R., Gee, B., &amp; Meiser-Stedman, R. (2019). A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma. Journal of affective disorders, 255, 77--89. https://doi.org/10.1016/j.jad.2019.05.005</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n\n\n\n\n\n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Follow-Up Plan: Documented follow-up for a positive depression screening must include one or more of the following:\n\n* Referral to a provider for additional evaluation and assessment to formulate a follow-up plan for a positive depression screen\n\n* Pharmacological interventions (prescribed or active depression medication)\n\n* Other interventions or follow-up for the diagnosis or treatment of depression\n\n</td>\n\n\n</tr>\n\n\n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Screening: Completion of a clinical or diagnostic tool used to identify people at risk of developing or having a certain disease or condition, even in the absence of symptoms.\n</td>\n\n\n</tr>\n\n\n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n\n<td class=\"content-container\">Standardized Depression Screening Tool: A normalized and validated depression screening tool developed for the patient population in which it is being utilized. Examples of standardized depression screening tools include but are not limited to:\n\n* Adolescent Screening Tools (12-17 years)\n\n  * Patient Health Questionnaire for Adolescents (PHQ-A)\n\n  * Beck Depression Inventory-Primary Care Version (BDI-PC)\n\n  * Mood Feeling Questionnaire (MFQ)\n\n  * Center for Epidemiologic Studies Depression Scale (CES-D)\n\n  * Patient Health Questionnaire (PHQ-9)\n\n  * Pediatric Symptom Checklist (PSC-17)\n\n  * Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ-2)\n\n* Adult Screening Tools (18 years and older)\n\n  * Patient Health Questionnaire (PHQ-9)\n\n  * Beck Depression Inventory (BDI or BDI-II)\n\n  * Center for Epidemiologic Studies Depression Scale (CES-D)\n\n  * Depression Scale (DEPS)\n\n  * Duke Anxiety-Depression Scale (DADS)\n\n  * Geriatric Depression Scale (GDS)\n\n  * Cornell Scale for Depression in Dementia (CSDD)\n\n  * PRIME MD-PHQ-2\n\n  * Hamilton Rating Scale for Depression (HAM-D)\n\n  * Quick Inventory of Depressive Symptomatology Self-Report (QID-SR)\n\n  * Computerized Adaptive Testing Depression Inventory (CAT-DI)\n\n  * Computerized Adaptive Diagnostic Screener (CAD-MDD)\n\n* Perinatal Screening Tools\n\n  * Edinburgh Postnatal Depression Scale\n\n  * Postpartum Depression Screening Scale\n\n  * Patient Health Questionnaire 9 (PHQ-9)\n\n  * Beck Depression Inventory\n\n  * Beck Depression Inventory-II\n\n  * Center for Epidemiologic Studies Depression Scale\n\n  * Zung Self-rating Depression Scale\n\n</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n\n<td class=\"content-container\">The intent of the measure is to screen all patients for depression except those with previous diagnosis of bipolar disorder. Patients who have ever been diagnosed with bipolar disorder prior to the qualifying encounter will be excluded from the measure regardless of whether the diagnosis is active or not. A depression screen is completed on the date of the encounter or up to 14 calendar days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan must be documented on the date of or up to two calendar days after the date of the encounter, such as referral to a provider for additional evaluation, pharmacological interventions, or other interventions for the treatment of depression. An example to illustrate the follow-up plan documentation timing: if the encounter is on a Monday from 3-4 pm (day 0) and the patient screens positive, the clinician has through anytime on Wednesday (day 2) to complete follow-up plan documentation. This measure does not require documentation of a specific score, just whether results of the normalized and validated depression screening tool used are considered positive or negative. Each standardized screening tool provides guidance on whether a particular score is considered positive for depression. The measure is not prescriptive in the specific screening tool being used and provides no hierarchy for acceptance of one tool over another. In the case where two screenings are documented on the same date/time with different results (one positive and one negative), the measure only assesses the most recent screening. Since both screenings are both considered the most recent, the patient will be captured in the numerator if the positive screening result also includes documentation of an intervention following the positive screen. This eCQM is a patient-based measure. Depression screening is required once per measurement period, not at all encounters. Screening Tools:\n\n* An age-appropriate, standardized, and validated depression screening tool must be used for numerator compliance.\n\n* The name of the age-appropriate standardized depression screening tool utilized must be documented in the medical record.\n\n* The depression screening must be reviewed and addressed by the provider, filing the code, on the date of the encounter. Positive pre-screening results indicating a patient is at high risk for self-harm should receive more urgent intervention as determined by the provider practice.\n\n* The screening should occur during a qualifying encounter or up to 14 calendar days prior to the date of the qualifying encounter.\n\n* The measure assesses the most recent depression screening completed either during the qualifying encounter or within the 14 calendar days prior to that encounter. Therefore, a clinician would not be able to complete another screening at the time of the encounter to count towards a follow-up, because that would serve as the most recent screening. In order to satisfy the follow-up requirement for a patient screening positively, the eligible clinician would need to provide one of the aforementioned follow-up actions, which does not include use of a standardized depression screening tool.\n\nFollow-Up Plan:\n\nWhile there are many validated depression screening tools, they are not necessarily diagnostic tools. Patients with elevated depression screening scores should be followed by a clinician to evaluate whether a depression diagnosis is appropriate, but a medication and/or referral are not always indicated for a positive score. In these cases, a follow up plan is appropriate.\n\nThe follow-up plan MUST still be provided for and discussed with the patient during the qualifying encounter used to evaluate the numerator. However, documentation of the follow-up plan can occur up to two calendar days after the qualifying encounter, in accordance with the policies of an eligible clinician or provider's practice or health system. All services should be documented during, or as soon as practicable, after the qualifying encounter in order to maintain an accurate medical record.\n\nExamples of a follow-up plan include but are not limited to:\n\n* Referral to a provider or program for further evaluation for depression, for example, referral to a psychiatrist, psychiatric nurse practitioner, psychologist, clinical social worker, mental health counselor, or other mental health service such as family or group therapy, support group, depression management program, or other service for treatment of depression\n\n* Other interventions designed to treat depression such as behavioral health evaluation, psychotherapy, pharmacological interventions, or additional treatment options.\n\n* Exercise regimens, education counseling, coping support, and completion of a mental health crisis plan.\n\nShould a patient screen positive for depression, a clinician should:\n\n* Only order pharmacological intervention when appropriate and after sufficient diagnostic evaluation. However, for the purposes of this measure, additional screening and assessment during the qualifying encounter will not qualify as a follow-up plan.\n\n* Opt to complete a suicide risk assessment when appropriate and based on individual patient characteristics. However, for the purposes of this measure, a suicide risk assessment or an additional screening using a standardized tool will not qualify as a follow-up plan.\n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS2v15. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6.0.0 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n</td>\n\n\n</tr>\n\n\n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Summary</th>\n\n\n\n<td class=\"content-container\">Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter\n</td>\n\n\n</tr>\n\n  \n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n\n<td class=\"content-container\">boolean</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n\n<td class=\"content-container\">\n    Proportion\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n\n<td class=\"content-container\">\n    Increased score indicates improvement\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    Process\n\n\n</td>\n\n\n</tr>\n\n\n\n\n  \n  \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: InitialPopulation_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">All patients aged 12 years and older at the beginning of the measurement period with at least one qualifying encounter during the measurement period\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-InitialPopulation_1\">Initial Population</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Denominator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">Equals Initial Population\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-Denominator_1\">Denominator</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exclusion</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorExclusion_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">Patients who have ever been diagnosed with bipolar disorder at any time prior to the qualifying encounter\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-DenominatorExclusion_1\">Denominator Exclusions</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exception</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorException_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">Patient Reason(s) - Patient refuses to participate in or complete the depression screening\n\nOR\n\nMedical Reason(s) - Documentation of medical reason for not screening patient for depression (e.g., cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status)\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-DenominatorException_1\">Denominator Exceptions</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Numerator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">Patients screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter or an active depression medication overlaps the date of the qualifying encounter\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-Numerator_1\">Numerator</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n    \n\n  \n\n\n  \n\n\n\n\n\n\n\n  \n    \n    \n    \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Guidance Guidance</th>\n\n\n\n<td class=\"content-container\">&lt;p&gt;For every patient evaluated by this measure also identify payer, race, ethnicity, and sex&lt;/p&gt;</td>\n\n\n</tr>\n\n  \n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-ethnicity\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Ethnicity\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms2fhirpcsdepscreenandfollowup-sde-ethnicity\">SDE Ethnicity</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-payer\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Payer\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms2fhirpcsdepscreenandfollowup-sde-payer\">SDE Payer</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-race\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Race\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms2fhirpcsdepscreenandfollowup-sde-race\">SDE Race</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-sex\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Sex\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms2fhirpcsdepscreenandfollowup-sde-sex\">SDE Sex</a> \n        \n      \n    \n  </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n\n<td class=\"content-container\"><a href=\"Library-CMS2FHIRPCSDepScreenAndFollowUp.html\">CMS2FHIRPCSDepScreenAndFollowUp</a></td>\n\n\n</tr>\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Contents</th>\n  <td class=\"content-container\">\n    <em><a href=\"#population-criteria\">Population Criteria</a></em>\n    <br/>\n    <em><a href=\"#definitions\">Logic Definitions</a></em>\n    <br/>\n    <em><a href=\"#terminology\">Terminology</a></em>\n    <br/>\n    <em><a href=\"#dependencies\">Dependencies</a></em>\n    <br/>\n    <em><a href=\"#data-requirements\">Data Requirements</a></em>\n    <br/>\n    <em><a href=\"#parameters\">Parameters</a></em>\n    <br/>\n  </td>\n</tr>\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n  \n  \n  \n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Initial Population\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-InitialPopulation_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  &quot;Patient Age 12 Years or Older at Start of Measurement Period&quot;\n    and exists ( &quot;Qualifying Encounter During Measurement Period&quot; )</code></pre>\n    \n      \n      <a href=\"#cms2fhirpcsdepscreenandfollowup-initial-population\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Denominator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-Denominator_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n    \n      \n      <a href=\"#cms2fhirpcsdepscreenandfollowup-denominator\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Denominator Exclusion\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-DenominatorExclusion_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  exists &quot;History of Bipolar Diagnosis Before Qualifying Encounter&quot;</code></pre>\n    \n      \n      <a href=\"#cms2fhirpcsdepscreenandfollowup-denominator-exclusions\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Denominator Exception\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-DenominatorException_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  false</code></pre>\n    \n      \n      <a href=\"#cms2fhirpcsdepscreenandfollowup-denominator-exceptions\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Numerator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-Numerator_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  ( &quot;Patient Age 12 to 16 Years at Start of Measurement Period&quot;\n      and ( &quot;Has Most Recent Adolescent Screening Negative&quot;\n          or exists &quot;Most Recent Adolescent Depression Screening Positive and Follow Up Provided&quot;\n      )\n  )\n    or ( &quot;Patient Age 17 Years at Start of Measurement Period&quot;\n        and ( &quot;Has Most Recent Adolescent Screening Negative&quot;\n            or exists &quot;Most Recent Adolescent Depression Screening Positive and Follow Up Provided&quot;\n            or &quot;Has Most Recent Adult Screening Negative&quot;\n            or exists &quot;Most Recent Adult Depression Screening Positive and Follow Up Provided&quot;\n        )\n    )\n    or ( &quot;Patient Age 18 Years or Older at Start of Measurement Period&quot;\n        and ( &quot;Has Most Recent Adult Screening Negative&quot;\n            or exists &quot;Most Recent Adult Depression Screening Positive and Follow Up Provided&quot;\n        )\n    )</code></pre>\n    \n      \n      <a href=\"#cms2fhirpcsdepscreenandfollowup-numerator\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n    \n\n  \n\n\n  \n\n\n  \n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n  \n  \n          \n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n    when Patient.sex() = '248153007' then &quot;Male (finding)&quot;\n    when Patient.sex() = '248152002' then &quot;Female (finding)&quot;\n    else null\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  [USQualityCore.Coverage: type in &quot;Payer Type&quot;] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-patient-age-12-to-16-years-at-start-of-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient Age 12 to 16 Years at Start of Measurement Period&quot;:\n  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) in Interval[12, 16]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-qualifying-encounter-during-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Qualifying Encounter During Measurement Period&quot;:\n  ( [USQualityCore.Encounter: &quot;Encounter to Screen for Depression&quot;]\n    union [USQualityCore.Encounter: &quot;Physical Therapy Evaluation&quot;]\n    union [USQualityCore.Encounter: &quot;Telephone Visits&quot;] ) QualifyingEncounter\n    where QualifyingEncounter.period during day of &quot;Measurement Period&quot;\n      and QualifyingEncounter.status = 'finished'</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-most-recent-adolescent-depression-screening\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\nTODO: Needs to be reassessed given the pattern change for ObservationCancelled, this should really be a ServiceRequest with a TaskRejected, yes?\ndefine &quot;Medical or Patient Reason for Not Screening Adolescent for Depression&quot;:\n  [USQualityCore.ObservationCancelled: code ~ &quot;Adolescent depression screening assessment&quot;] NoAdolescentScreen\n    with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n      such that NoAdolescentScreen.issued during day of QualifyingEncounter.period\n    where ( NoAdolescentScreen.notDoneReason ~ &quot;Depression screening declined (situation)&quot;\n        or NoAdolescentScreen.notDoneReason in &quot;Medical Reason&quot;\n    )\n\ndefine &quot;Medical or Patient Reason for Not Screening Adult for Depression&quot;:\n  [USQualityCore.ObservationCancelled: code ~ &quot;Adult depression screening assessment&quot;] NoAdultScreen\n    with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n      such that NoAdultScreen.issued during day of QualifyingEncounter.period\n    where ( NoAdultScreen.notDoneReason ~ &quot;Depression screening declined (situation)&quot;\n        or NoAdultScreen.notDoneReason in &quot;Medical Reason&quot;\n    )\n*/\n\ndefine &quot;Most Recent Adolescent Depression Screening&quot;:\n  Last([USQualityCore.ObservationScreeningAssessment: &quot;Adolescent depression screening assessment&quot;] AdolescentDepressionScreening\n      with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n        such that AdolescentDepressionScreening.effective.toInterval() 14 days or less on or before day of start of QualifyingEncounter.period\n          and AdolescentDepressionScreening.value is not null\n          and AdolescentDepressionScreening.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval()\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-has-most-recent-adolescent-screening-negative\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Most Recent Adolescent Screening Negative&quot;:\n  ( &quot;Most Recent Adolescent Depression Screening&quot; AdolescentScreen\n      where AdolescentScreen.value ~ &quot;Depression screening negative (finding)&quot;\n  ) is not null</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-follow-up-intervention-for-positive-adolescent-depression-screening\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\nTODO: Need to reassess how we are representing given no ObservationCancelled profile\n  ( exists &quot;Medical or Patient Reason for Not Screening Adolescent for Depression&quot;\n      and not &quot;Has Adolescent Depression Screening&quot;\n  )\n    or ( exists &quot;Medical or Patient Reason for Not Screening Adult for Depression&quot;\n        and not &quot;Has Adult Depression Screening&quot;\n    )\n*/\n\ndefine &quot;Follow Up Intervention for Positive Adolescent Depression Screening&quot;:\n  ( ( [USQualityCore.MedicationRequest: &quot;Adolescent Depression Medications&quot;] AdolescentMed\n        with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n          such that &quot;Most Recent Adolescent Depression Screening&quot;.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n            and AdolescentMed.medicationRequestPeriod ( ) overlaps after day of QualifyingEncounter.period\n            and &quot;Most Recent Adolescent Depression Screening&quot;.value ~ &quot;Depression screening positive (finding)&quot;\n            and AdolescentMed.status in { 'active', 'completed' }\n            and AdolescentMed.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n    )\n      union ( [USQualityCore.ServiceRequest: &quot;Referral for Adolescent Depression&quot;] AdolescentReferral\n          where AdolescentReferral.status in { 'active', 'completed' }\n      )\n      union ( [USQualityCore.Procedure: &quot;Follow Up for Adolescent Depression&quot;] AdolescentFollowUp\n          where AdolescentFollowUp.status = 'completed'\n      )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-most-recent-adolescent-depression-screening-positive-and-follow-up-provided\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent Adolescent Depression Screening Positive and Follow Up Provided&quot;:\n  from\n    &quot;Most Recent Adolescent Depression Screening&quot; LastAdolescentScreen,\n    &quot;Follow Up Intervention for Positive Adolescent Depression Screening&quot; FollowUpPositiveAdolescentScreen,\n    &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n    where LastAdolescentScreen.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n      and LastAdolescentScreen.value ~ &quot;Depression screening positive (finding)&quot;\n      and ( start of FollowUpPositiveAdolescentScreen.performed.toInterval ( ) during QualifyingEncounter.period\n          or FollowUpPositiveAdolescentScreen.authoredOn 2 days or less on or after day of end of QualifyingEncounter.period\n      )\n      and ( Coalesce(start of FollowUpPositiveAdolescentScreen.performed.toInterval(), FollowUpPositiveAdolescentScreen.authoredOn) during day of &quot;Measurement Period&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-patient-age-17-years-at-start-of-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient Age 17 Years at Start of Measurement Period&quot;:\n  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) = 17</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-most-recent-adult-depression-screening\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent Adult Depression Screening&quot;:\n  Last([USQualityCore.ObservationScreeningAssessment: &quot;Adult depression screening assessment&quot;] AdultDepressionScreening\n      with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n        such that AdultDepressionScreening.effective.toInterval() 14 days or less on or before day of start of QualifyingEncounter.period\n          and AdultDepressionScreening.value is not null\n          and AdultDepressionScreening.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval()\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-has-most-recent-adult-screening-negative\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Most Recent Adult Screening Negative&quot;:\n  ( &quot;Most Recent Adult Depression Screening&quot; AdultScreen\n      where AdultScreen.value ~ &quot;Depression screening negative (finding)&quot;\n  ) is not null</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-follow-up-intervention-for-positive-adult-depression-screening\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Follow Up Intervention for Positive Adult Depression Screening&quot;:\n  ( ( [USQualityCore.MedicationRequest: &quot;Adult Depression Medications&quot;] AdultMed\n        with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n          such that &quot;Most Recent Adult Depression Screening&quot;.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n            and AdultMed.medicationRequestPeriod ( ) overlaps after day of QualifyingEncounter.period\n            and &quot;Most Recent Adult Depression Screening&quot;.value ~ &quot;Depression screening positive (finding)&quot;\n            and AdultMed.status in { 'active', 'completed' }\n            and AdultMed.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n    )\n      union ( [USQualityCore.ServiceRequest: &quot;Referral for Adult Depression&quot;] AdultReferral\n          where AdultReferral.status in { 'active', 'completed' }\n      )\n      union ( [USQualityCore.Procedure: &quot;Follow Up for Adult Depression&quot;] AdultFollowUp\n          where AdultFollowUp.status = 'completed'\n      )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-most-recent-adult-depression-screening-positive-and-follow-up-provided\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent Adult Depression Screening Positive and Follow Up Provided&quot;:\n  from\n    &quot;Most Recent Adult Depression Screening&quot; LastAdultScreen,\n    &quot;Follow Up Intervention for Positive Adult Depression Screening&quot; FollowUpPositiveAdultScreen,\n    &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n    where LastAdultScreen.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n      and LastAdultScreen.value ~ &quot;Depression screening positive (finding)&quot;\n      and ( start of FollowUpPositiveAdultScreen.performed.toInterval ( ) during QualifyingEncounter.period\n          or FollowUpPositiveAdultScreen.authoredOn 2 days or less on or after day of end of QualifyingEncounter.period\n      )\n      and ( Coalesce(start of FollowUpPositiveAdultScreen.performed.toInterval(), FollowUpPositiveAdultScreen.authoredOn) during day of &quot;Measurement Period&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-patient-age-18-years-or-older-at-start-of-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient Age 18 Years or Older at Start of Measurement Period&quot;:\n  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-numerator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  ( &quot;Patient Age 12 to 16 Years at Start of Measurement Period&quot;\n      and ( &quot;Has Most Recent Adolescent Screening Negative&quot;\n          or exists &quot;Most Recent Adolescent Depression Screening Positive and Follow Up Provided&quot;\n      )\n  )\n    or ( &quot;Patient Age 17 Years at Start of Measurement Period&quot;\n        and ( &quot;Has Most Recent Adolescent Screening Negative&quot;\n            or exists &quot;Most Recent Adolescent Depression Screening Positive and Follow Up Provided&quot;\n            or &quot;Has Most Recent Adult Screening Negative&quot;\n            or exists &quot;Most Recent Adult Depression Screening Positive and Follow Up Provided&quot;\n        )\n    )\n    or ( &quot;Patient Age 18 Years or Older at Start of Measurement Period&quot;\n        and ( &quot;Has Most Recent Adult Screening Negative&quot;\n            or exists &quot;Most Recent Adult Depression Screening Positive and Follow Up Provided&quot;\n        )\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-patient-age-12-years-or-older-at-start-of-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient Age 12 Years or Older at Start of Measurement Period&quot;:\n  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 12</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-initial-population\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  &quot;Patient Age 12 Years or Older at Start of Measurement Period&quot;\n    and exists ( &quot;Qualifying Encounter During Measurement Period&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-denominator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-history-of-bipolar-diagnosis-before-qualifying-encounter\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;History of Bipolar Diagnosis Before Qualifying Encounter&quot;:\n  [USQualityCore.ConditionProblemsHealthConcerns: &quot;Bipolar Disorder&quot;] BipolarDiagnosis\n    with &quot;Qualifying Encounter During Measurement Period&quot; QualifyingEncounter\n      such that BipolarDiagnosis.prevalenceInterval ( ) starts before day of start of QualifyingEncounter.period</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-denominator-exclusions\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  exists &quot;History of Bipolar Diagnosis Before Qualifying Encounter&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS2FHIRPCSDepScreenAndFollowUp</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms2fhirpcsdepscreenandfollowup-denominator-exceptions\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  false</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CumulativeMedicationDuration</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cumulativemedicationduration-medicationrequestperiod\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\nCalculates the Medication Period for a single MedicationRequest.\nMedicationRequest instances provided to this function are expected\nto conform to the [MMEMedicationRequest](http://build.fhir.org/ig/cqframework/opioid-mme-r4/StructureDefinition-mmemedicationrequest.html)\nprofile, which expects:\n* 1 and only 1 dosageInstruction, multiple dosageInstruction elements will result in an error\n* 1 and only 1 doseAndRate, multiple doseAndRate elements will result in an error\n* 1 timing with 1 repeat, missing timing or repeat elements will result in a null\n* frequency, frequencyMax, defaulting to 1\n* period, periodUnit, defaulting to 1 'd'\n* timeOfDay\n* doseQuantity or doseRange, missing doseQuantity and doseRange will result in a null\nNote that MedicationRequest status is not considered by this calculation, as the\nlist of MedicationRequest instances provided to this function should already have\nconsidered appropriate statuses, depending on the use case, typically `completed`.\n\nNOTE: Updated return to use &quot;date from end of boundsPeriod&quot; to ensure result is Interval&lt;Date&gt;\n*/\ndefine fluent function medicationRequestPeriod(Request MedicationRequest):\n  Request R\n    let\n      dosage: singleton from R.dosageInstruction,\n      doseAndRate: singleton from dosage.doseAndRate,\n      timing: dosage.timing,\n      frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),\n      period: Quantity(timing.repeat.period, timing.repeat.periodUnit),\n      doseRange: doseAndRate.dose as FHIR.Range,\n      doseQuantity: doseAndRate.dose as FHIR.SimpleQuantity,\n\n      dose: Coalesce(end of doseRange, doseQuantity),\n      dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),\n      boundsPeriod: timing.repeat.bounds as Period,\n      // TODO: this isn't working as expected, convert results in null\n      //daysSupply: (convert(R.dispenseRequest.expectedSupplyDuration) to days).value,\n      daysSupply: (R.dispenseRequest.expectedSupplyDuration).value,\n      quantity: R.dispenseRequest.quantity,\n      refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),\n      startDate:\n        Coalesce(\n          date from start of boundsPeriod,\n          date from R.authoredOn,\n          date from start of R.dispenseRequest.validityPeriod\n        ),\n      totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)\n    return\n      if startDate is not null and totalDaysSupplied is not null then\n        Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]\n      else if startDate is not null and boundsPeriod.&quot;end&quot; is not null then\n        Interval[startDate, date from end of boundsPeriod]\n      else\n        null</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CumulativeMedicationDuration</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cumulativemedicationduration-quantity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/**********************************************************************/\n/* Functions in this region are copied from opioid-mme-r4             */\n/**********************************************************************/\n\ndefine function Quantity(value Decimal, unit String):\n  if value is not null then\n    System.Quantity { value: value, unit: unit }\n  else\n    null</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CumulativeMedicationDuration</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cumulativemedicationduration-todaily\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n Goal is to get to number of days\n Two broad approaches to the calculation:\n  1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered\n  2) Based on relevant period, determine a covered interval and calculate the length of that interval in days\n\nThis topic covers several use cases and illustrates how to calculate Cumulative\nMedication Duration for each type of medication resource using the supply and\nfrequency approach.\n*/\n\n/*\n  For the first approach, we need to get from frequency to a frequency/day\n  So we define ToDaily\n*/\n\n/*\n  Calculates daily frequency given frequency within a period\n*/\ndefine function ToDaily(frequency System.Integer, period System.Quantity):\n  case period.unit\n    when 'h' then frequency * (24.0 / period.value)\n    when 'min' then frequency * (24.0 / period.value) * 60\n    when 's' then frequency * (24.0 / period.value) * 60 * 60\n    when 'd' then frequency * (24.0 / period.value) / 24\n    when 'wk' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    when 'hour' then frequency * (24.0 / period.value)\n    when 'minute' then frequency * (24.0 / period.value) * 60\n    when 'second' then frequency * (24.0 / period.value) * 60 * 60\n    when 'day' then frequency * (24.0 / period.value) / 24\n    when 'week' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    when 'hours' then frequency * (24.0 / period.value)\n    when 'minutes' then frequency * (24.0 / period.value) * 60\n    when 'seconds' then frequency * (24.0 / period.value) * 60 * 60\n    when 'days' then frequency * (24.0 / period.value) / 24\n    when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' &amp; period.unit)\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value string): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todate\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDate(value date): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.&quot;start&quot; is null then\n            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]\n        else\n            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value EncounterStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value dateTime): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value instant): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toquantity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocalendarunit\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ObservationStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toconcept\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocode\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todecimal\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDecimal(value decimal): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value UnitsOfTime): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity\n*/\ndefine function ToInterval(range FHIR.Range):\n    if range is null then\n        null\n    else\n        Interval[ToQuantity(range.low), ToQuantity(range.high)]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tointeger\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToInteger(value integer): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value MedicationRequestStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value MedicationRequestIntent): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ServiceRequestStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ProcedureStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-ext\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n  singleton from domainResource.exts(url)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-exts\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n  domainResource.extension E\n    where E.url = url\n    return E</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):\n  case\n    when choice is FHIR.dateTime then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n    when choice is FHIR.Period then\n      FHIRHelpers.ToInterval(choice as FHIR.Period)\n    when choice is FHIR.instant then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n    when choice is FHIR.Age then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n    when choice is FHIR.Range then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n    when choice is FHIR.Timing then\n      Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n    when choice is FHIR.string then\n      Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n    else\n      null as Interval&lt;DateTime&gt;\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-ext\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n  singleton from element.exts(url)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-exts\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n  element.extension E\n    where E.url = url\n    return E</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-prevalenceinterval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ &quot;active&quot;\n  or condition.clinicalStatus ~ &quot;recurrence&quot;\n  or condition.clinicalStatus ~ &quot;relapse&quot; then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n  (end of condition.abatementInterval()) abatementDate\n    return \n\t  if abatementDate is null then\n        Interval[start of condition.onset.toInterval(), abatementDate)\n      else\n        Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-abatementinterval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf 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\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n  if condition.abatement is FHIR.dateTime then\n    Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n  else if condition.abatement is FHIR.Period then\n    FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n  else if condition.abatement is FHIR.string then\n    Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n  else if condition.abatement is FHIR.Age then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n  else if condition.abatement is FHIR.Range then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n  else if condition.abatement is FHIR.boolean then\n    Interval[end of condition.onset.toInterval(), condition.recordedDate)\n  else \n    null</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function ethnicity(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n    return {\n      ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function race(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n    return {\n      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n  \n  \n  \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system SNOMEDCT\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system LOINC\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://loinc.org</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system ConditionClinicalStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Encounter to Screen for Depression\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1916/expansion\">Encounter to Screen for Depression</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1916</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Physical Therapy Evaluation\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1022/expansion\">Physical Therapy Evaluation</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Telephone Visits\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion\">Telephone Visits</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Adolescent Depression Medications\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1567/expansion\">Adolescent Depression Medications</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1567</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Referral for Adolescent Depression\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1570/expansion\">Referral for Adolescent Depression</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1570</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Follow Up for Adolescent Depression\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1569/expansion\">Follow Up for Adolescent Depression</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1569</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Adult Depression Medications\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1566/expansion\">Adult Depression Medications</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1566</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Referral for Adult Depression\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1571/expansion\">Referral for Adult Depression</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1571</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Follow Up for Adult Depression\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1568/expansion\">Follow Up for Adult Depression</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1568</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Payer Type\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Bipolar Disorder\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.67.1.101.1.128/expansion\">Bipolar Disorder</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128</tt>\n    \n  </td>\n</tr>\n \n\n\n  \n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Male (finding)\n        <br/>\n      \n      <em>Code</em>: 248153007\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Female (finding)\n        <br/>\n      \n      <em>Code</em>: 248152002\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Adolescent depression screening assessment\n        <br/>\n      \n      <em>Code</em>: 73831-0\n      <br/>\n      <em>System</em>: <tt>http://loinc.org</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Depression screening negative (finding)\n        <br/>\n      \n      <em>Code</em>: 428171000124102\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Depression screening positive (finding)\n        <br/>\n      \n      <em>Code</em>: 428181000124104\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Adult depression screening assessment\n        <br/>\n      \n      <em>Code</em>: 73832-8\n      <br/>\n      <em>System</em>: <tt>http://loinc.org</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n      <em>Code</em>: active\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n      <em>Code</em>: recurrence\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n      <em>Code</em>: relapse\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n  \n  \n  \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: USQualityCore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <code>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</code>\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: USCore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://build.fhir.org/ig/HL7/us-cql-ig/Library-USCore-ModelInfo.html\">http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: FHIR model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html\">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library SDE\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-SupplementalDataElements.html\">SupplementalDataElementsversion: null6.1.000)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|6.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRHelpers\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html\">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library USCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://build.fhir.org/ig/HL7/us-cql-ig/Library-USCoreCommon.html\">http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRCommon.html\">http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library CMD\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://build.fhir.org/ig/HL7/us-cql-ig/Library-CumulativeMedicationDuration.html\">http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot</tt>\n    \n  </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n  \n  \n\n\n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n  \n  \n  \n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: ombCategory, detailed, text\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1916/expansion\">Encounter to Screen for Depression</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1022/expansion\">Physical Therapy Evaluation</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion\">Telephone Visits</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: birthDate\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, effective, value, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      <a href=\"https://loinc.org/73831-0\">LOINC: 73831-0</a> (Adolescent depression screening assessment)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, effective, value, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      <a href=\"https://loinc.org/73832-8\">LOINC: 73832-8</a> (Adult depression screening assessment)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: effective, value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Medication\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medication</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: id, code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1567/expansion\">Adolescent Depression Medications</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Medication\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medication</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: id, code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1566/expansion\">Adult Depression Medications</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, status, intent\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1567/expansion\">Adolescent Depression Medications</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication.reference, status, intent\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, status, intent\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1566/expansion\">Adult Depression Medications</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: ServiceRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1570/expansion\">Referral for Adolescent Depression</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: ServiceRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1571/expansion\">Referral for Adult Depression</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1569/expansion\">Follow Up for Adolescent Depression</a>\n    <br/> \n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Path</em>: status</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      [not stated]: completed (completed)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1568/expansion\">Follow Up for Adult Depression</a>\n    <br/> \n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Path</em>: status</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      [not stated]: completed (completed)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Coverage\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/condition.html\">Condition</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: abatement, onset, recordedDate, clinicalStatus\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.67.1.101.1.128/expansion\">Bipolar Disorder</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n  \n  \n  <tr>\n  \n\n<th scope=\"row\" class=\"row-header\"/>\n\n\n  <td class=\"content-container\">\n    <table>\n      <thead>\n        <tr>\n          <td><em>Name</em></td>\n          <td><em>Use</em></td>\n          <td><em>Card.</em></td>\n          <td><em>Type</em></td>\n          <td><em>Documentation</em></td>\n        </tr>\n      </thead>\n      <tbody>\n      \n        <tr>\n          <td>Measurement Period</td>\n          <td>In</td>\n          <td>0..1</td>\n          <td>Period</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>ErrorLevel</td>\n          <td>In</td>\n          <td>0..1</td>\n          <td>string</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Sex</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Coding</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Numerator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Payer</td>\n          <td>Out</td>\n          <td>0..*</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Initial Population</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Ethnicity</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator Exclusions</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Race</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator Exceptions</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n      </tbody>\n    </table>\n  </td>\n</tr>\n\n  \n  \n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
      },
      "contained" : [
        {
          "resourceType" : "Library",
          "id" : "effective-data-requirements",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "248153007",
                "display" : "Male (finding)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "248152002",
                "display" : "Female (finding)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "73831-0",
                "display" : "Adolescent depression screening assessment"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "428171000124102",
                "display" : "Depression screening negative (finding)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "428181000124104",
                "display" : "Depression screening positive (finding)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "73832-8",
                "display" : "Adult depression screening assessment"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code" : "active"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code" : "recurrence"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code" : "relapse"
              }
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Sex"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.sex() = '248153007' then \"Male (finding)\"\n    when Patient.sex() = '248152002' then \"Female (finding)\"\n    else null\n  end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 0
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Sex"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Sex\":\n  SDE.\"SDE Sex\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 1
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Patient Age 12 to 16 Years at Start of Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Patient Age 12 to 16 Years at Start of Measurement Period\":\n  AgeInYearsAt(date from start of \"Measurement Period\") in Interval[12, 16]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 2
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Qualifying Encounter During Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Qualifying Encounter During Measurement Period\":\n  ( [USQualityCore.Encounter: \"Encounter to Screen for Depression\"]\n    union [USQualityCore.Encounter: \"Physical Therapy Evaluation\"]\n    union [USQualityCore.Encounter: \"Telephone Visits\"] ) QualifyingEncounter\n    where QualifyingEncounter.period during day of \"Measurement Period\"\n      and QualifyingEncounter.status = 'finished'"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 3
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Most Recent Adolescent Depression Screening"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\nTODO: Needs to be reassessed given the pattern change for ObservationCancelled, this should really be a ServiceRequest with a TaskRejected, yes?\ndefine \"Medical or Patient Reason for Not Screening Adolescent for Depression\":\n  [USQualityCore.ObservationCancelled: code ~ \"Adolescent depression screening assessment\"] NoAdolescentScreen\n    with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n      such that NoAdolescentScreen.issued during day of QualifyingEncounter.period\n    where ( NoAdolescentScreen.notDoneReason ~ \"Depression screening declined (situation)\"\n        or NoAdolescentScreen.notDoneReason in \"Medical Reason\"\n    )\n\ndefine \"Medical or Patient Reason for Not Screening Adult for Depression\":\n  [USQualityCore.ObservationCancelled: code ~ \"Adult depression screening assessment\"] NoAdultScreen\n    with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n      such that NoAdultScreen.issued during day of QualifyingEncounter.period\n    where ( NoAdultScreen.notDoneReason ~ \"Depression screening declined (situation)\"\n        or NoAdultScreen.notDoneReason in \"Medical Reason\"\n    )\n*/\n\ndefine \"Most Recent Adolescent Depression Screening\":\n  Last([USQualityCore.ObservationScreeningAssessment: \"Adolescent depression screening assessment\"] AdolescentDepressionScreening\n      with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n        such that AdolescentDepressionScreening.effective.toInterval() 14 days or less on or before day of start of QualifyingEncounter.period\n          and AdolescentDepressionScreening.value is not null\n          and AdolescentDepressionScreening.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval()\n  )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 4
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Has Most Recent Adolescent Screening Negative"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Has Most Recent Adolescent Screening Negative\":\n  ( \"Most Recent Adolescent Depression Screening\" AdolescentScreen\n      where AdolescentScreen.value ~ \"Depression screening negative (finding)\"\n  ) is not null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 5
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Follow Up Intervention for Positive Adolescent Depression Screening"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\nTODO: Need to reassess how we are representing given no ObservationCancelled profile\n  ( exists \"Medical or Patient Reason for Not Screening Adolescent for Depression\"\n      and not \"Has Adolescent Depression Screening\"\n  )\n    or ( exists \"Medical or Patient Reason for Not Screening Adult for Depression\"\n        and not \"Has Adult Depression Screening\"\n    )\n*/\n\ndefine \"Follow Up Intervention for Positive Adolescent Depression Screening\":\n  ( ( [USQualityCore.MedicationRequest: \"Adolescent Depression Medications\"] AdolescentMed\n        with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n          such that \"Most Recent Adolescent Depression Screening\".effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n            and AdolescentMed.medicationRequestPeriod ( ) overlaps after day of QualifyingEncounter.period\n            and \"Most Recent Adolescent Depression Screening\".value ~ \"Depression screening positive (finding)\"\n            and AdolescentMed.status in { 'active', 'completed' }\n            and AdolescentMed.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n    )\n      union ( [USQualityCore.ServiceRequest: \"Referral for Adolescent Depression\"] AdolescentReferral\n          where AdolescentReferral.status in { 'active', 'completed' }\n      )\n      union ( [USQualityCore.Procedure: \"Follow Up for Adolescent Depression\"] AdolescentFollowUp\n          where AdolescentFollowUp.status = 'completed'\n      )\n  )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 6
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Most Recent Adolescent Depression Screening Positive and Follow Up Provided"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Most Recent Adolescent Depression Screening Positive and Follow Up Provided\":\n  from\n    \"Most Recent Adolescent Depression Screening\" LastAdolescentScreen,\n    \"Follow Up Intervention for Positive Adolescent Depression Screening\" FollowUpPositiveAdolescentScreen,\n    \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n    where LastAdolescentScreen.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n      and LastAdolescentScreen.value ~ \"Depression screening positive (finding)\"\n      and ( start of FollowUpPositiveAdolescentScreen.performed.toInterval ( ) during QualifyingEncounter.period\n          or FollowUpPositiveAdolescentScreen.authoredOn 2 days or less on or after day of end of QualifyingEncounter.period\n      )\n      and ( Coalesce(start of FollowUpPositiveAdolescentScreen.performed.toInterval(), FollowUpPositiveAdolescentScreen.authoredOn) during day of \"Measurement Period\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 7
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Patient Age 17 Years at Start of Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Patient Age 17 Years at Start of Measurement Period\":\n  AgeInYearsAt(date from start of \"Measurement Period\") = 17"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 8
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Most Recent Adult Depression Screening"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Most Recent Adult Depression Screening\":\n  Last([USQualityCore.ObservationScreeningAssessment: \"Adult depression screening assessment\"] AdultDepressionScreening\n      with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n        such that AdultDepressionScreening.effective.toInterval() 14 days or less on or before day of start of QualifyingEncounter.period\n          and AdultDepressionScreening.value is not null\n          and AdultDepressionScreening.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval()\n  )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 9
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Has Most Recent Adult Screening Negative"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Has Most Recent Adult Screening Negative\":\n  ( \"Most Recent Adult Depression Screening\" AdultScreen\n      where AdultScreen.value ~ \"Depression screening negative (finding)\"\n  ) is not null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 10
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Follow Up Intervention for Positive Adult Depression Screening"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Follow Up Intervention for Positive Adult Depression Screening\":\n  ( ( [USQualityCore.MedicationRequest: \"Adult Depression Medications\"] AdultMed\n        with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n          such that \"Most Recent Adult Depression Screening\".effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n            and AdultMed.medicationRequestPeriod ( ) overlaps after day of QualifyingEncounter.period\n            and \"Most Recent Adult Depression Screening\".value ~ \"Depression screening positive (finding)\"\n            and AdultMed.status in { 'active', 'completed' }\n            and AdultMed.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n    )\n      union ( [USQualityCore.ServiceRequest: \"Referral for Adult Depression\"] AdultReferral\n          where AdultReferral.status in { 'active', 'completed' }\n      )\n      union ( [USQualityCore.Procedure: \"Follow Up for Adult Depression\"] AdultFollowUp\n          where AdultFollowUp.status = 'completed'\n      )\n  )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 11
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Most Recent Adult Depression Screening Positive and Follow Up Provided"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Most Recent Adult Depression Screening Positive and Follow Up Provided\":\n  from\n    \"Most Recent Adult Depression Screening\" LastAdultScreen,\n    \"Follow Up Intervention for Positive Adult Depression Screening\" FollowUpPositiveAdultScreen,\n    \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n    where LastAdultScreen.effective.toInterval ( ) starts 14 days or less on or before day of start of QualifyingEncounter.period\n      and LastAdultScreen.value ~ \"Depression screening positive (finding)\"\n      and ( start of FollowUpPositiveAdultScreen.performed.toInterval ( ) during QualifyingEncounter.period\n          or FollowUpPositiveAdultScreen.authoredOn 2 days or less on or after day of end of QualifyingEncounter.period\n      )\n      and ( Coalesce(start of FollowUpPositiveAdultScreen.performed.toInterval(), FollowUpPositiveAdultScreen.authoredOn) during day of \"Measurement Period\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 12
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Patient Age 18 Years or Older at Start of Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Patient Age 18 Years or Older at Start of Measurement Period\":\n  AgeInYearsAt(date from start of \"Measurement Period\") >= 18"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 13
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Numerator"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Numerator\":\n  ( \"Patient Age 12 to 16 Years at Start of Measurement Period\"\n      and ( \"Has Most Recent Adolescent Screening Negative\"\n          or exists \"Most Recent Adolescent Depression Screening Positive and Follow Up Provided\"\n      )\n  )\n    or ( \"Patient Age 17 Years at Start of Measurement Period\"\n        and ( \"Has Most Recent Adolescent Screening Negative\"\n            or exists \"Most Recent Adolescent Depression Screening Positive and Follow Up Provided\"\n            or \"Has Most Recent Adult Screening Negative\"\n            or exists \"Most Recent Adult Depression Screening Positive and Follow Up Provided\"\n        )\n    )\n    or ( \"Patient Age 18 Years or Older at Start of Measurement Period\"\n        and ( \"Has Most Recent Adult Screening Negative\"\n            or exists \"Most Recent Adult Depression Screening Positive and Follow Up Provided\"\n        )\n    )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 14
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Patient Age 12 Years or Older at Start of Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Patient Age 12 Years or Older at Start of Measurement Period\":\n  AgeInYearsAt(date from start of \"Measurement Period\") >= 12"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 15
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Initial Population"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Initial Population\":\n  \"Patient Age 12 Years or Older at Start of Measurement Period\"\n    and exists ( \"Qualifying Encounter During Measurement Period\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 16
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator\":\n  \"Initial Population\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 17
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Payer"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Payer\":\n  [USQualityCore.Coverage: type in \"Payer Type\"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 18
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Payer"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 19
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Ethnicity"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Ethnicity\":\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 20
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Ethnicity"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 21
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "History of Bipolar Diagnosis Before Qualifying Encounter"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"History of Bipolar Diagnosis Before Qualifying Encounter\":\n  [USQualityCore.ConditionProblemsHealthConcerns: \"Bipolar Disorder\"] BipolarDiagnosis\n    with \"Qualifying Encounter During Measurement Period\" QualifyingEncounter\n      such that BipolarDiagnosis.prevalenceInterval ( ) starts before day of start of QualifyingEncounter.period"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 22
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator Exclusions"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator Exclusions\":\n  exists \"History of Bipolar Diagnosis Before Qualifying Encounter\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 23
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Race"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Race\":\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 24
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Race"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 25
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS2FHIRPCSDepScreenAndFollowUp"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator Exceptions"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator Exceptions\":\n  false"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 26
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value string): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 27
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "USCoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "sex"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 28
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "ext"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n  singleton from domainResource.exts(url)"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 29
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "exts"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n  domainResource.extension E\n    where E.url = url\n    return E"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 30
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value uri): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 31
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDate"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDate(value date): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 32
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 33
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value EncounterStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 34
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "toInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n  case\n    when choice is FHIR.dateTime then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n    when choice is FHIR.Period then\n      FHIRHelpers.ToInterval(choice as FHIR.Period)\n    when choice is FHIR.instant then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n    when choice is FHIR.Age then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n    when choice is FHIR.Range then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n    when choice is FHIR.Timing then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n    when choice is FHIR.string then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n    else\n      null as Interval<DateTime>\n  end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 35
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDateTime"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDateTime(value dateTime): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 36
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDateTime"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDateTime(value instant): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 37
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToQuantity"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n    end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 38
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToCalendarUnit"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 39
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ObservationStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 40
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToConcept"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 41
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToCode"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 42
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CumulativeMedicationDuration"
                },
                {
                  "url" : "name",
                  "valueString" : "medicationRequestPeriod"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\nCalculates the Medication Period for a single MedicationRequest.\nMedicationRequest instances provided to this function are expected\nto conform to the [MMEMedicationRequest](http://build.fhir.org/ig/cqframework/opioid-mme-r4/StructureDefinition-mmemedicationrequest.html)\nprofile, which expects:\n* 1 and only 1 dosageInstruction, multiple dosageInstruction elements will result in an error\n* 1 and only 1 doseAndRate, multiple doseAndRate elements will result in an error\n* 1 timing with 1 repeat, missing timing or repeat elements will result in a null\n* frequency, frequencyMax, defaulting to 1\n* period, periodUnit, defaulting to 1 'd'\n* timeOfDay\n* doseQuantity or doseRange, missing doseQuantity and doseRange will result in a null\nNote that MedicationRequest status is not considered by this calculation, as the\nlist of MedicationRequest instances provided to this function should already have\nconsidered appropriate statuses, depending on the use case, typically `completed`.\n\nNOTE: Updated return to use \"date from end of boundsPeriod\" to ensure result is Interval<Date>\n*/\ndefine fluent function medicationRequestPeriod(Request MedicationRequest):\n  Request R\n    let\n      dosage: singleton from R.dosageInstruction,\n      doseAndRate: singleton from dosage.doseAndRate,\n      timing: dosage.timing,\n      frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),\n      period: Quantity(timing.repeat.period, timing.repeat.periodUnit),\n      doseRange: doseAndRate.dose as FHIR.Range,\n      doseQuantity: doseAndRate.dose as FHIR.SimpleQuantity,\n\n      dose: Coalesce(end of doseRange, doseQuantity),\n      dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),\n      boundsPeriod: timing.repeat.bounds as Period,\n      // TODO: this isn't working as expected, convert results in null\n      //daysSupply: (convert(R.dispenseRequest.expectedSupplyDuration) to days).value,\n      daysSupply: (R.dispenseRequest.expectedSupplyDuration).value,\n      quantity: R.dispenseRequest.quantity,\n      refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),\n      startDate:\n        Coalesce(\n          date from start of boundsPeriod,\n          date from R.authoredOn,\n          date from start of R.dispenseRequest.validityPeriod\n        ),\n      totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)\n    return\n      if startDate is not null and totalDaysSupplied is not null then\n        Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]\n      else if startDate is not null and boundsPeriod.\"end\" is not null then\n        Interval[startDate, date from end of boundsPeriod]\n      else\n        null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 43
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CumulativeMedicationDuration"
                },
                {
                  "url" : "name",
                  "valueString" : "Quantity"
                },
                {
                  "url" : "statement",
                  "valueString" : "/**********************************************************************/\n/* Functions in this region are copied from opioid-mme-r4             */\n/**********************************************************************/\n\ndefine function Quantity(value Decimal, unit String):\n  if value is not null then\n    System.Quantity { value: value, unit: unit }\n  else\n    null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 44
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDecimal"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDecimal(value decimal): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 45
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value UnitsOfTime): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 46
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity\n*/\ndefine function ToInterval(range FHIR.Range):\n    if range is null then\n        null\n    else\n        Interval[ToQuantity(range.low), ToQuantity(range.high)]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 47
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CumulativeMedicationDuration"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDaily"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n Goal is to get to number of days\n Two broad approaches to the calculation:\n  1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered\n  2) Based on relevant period, determine a covered interval and calculate the length of that interval in days\n\nThis topic covers several use cases and illustrates how to calculate Cumulative\nMedication Duration for each type of medication resource using the supply and\nfrequency approach.\n*/\n\n/*\n  For the first approach, we need to get from frequency to a frequency/day\n  So we define ToDaily\n*/\n\n/*\n  Calculates daily frequency given frequency within a period\n*/\ndefine function ToDaily(frequency System.Integer, period System.Quantity):\n  case period.unit\n    when 'h' then frequency * (24.0 / period.value)\n    when 'min' then frequency * (24.0 / period.value) * 60\n    when 's' then frequency * (24.0 / period.value) * 60 * 60\n    when 'd' then frequency * (24.0 / period.value) / 24\n    when 'wk' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    when 'hour' then frequency * (24.0 / period.value)\n    when 'minute' then frequency * (24.0 / period.value) * 60\n    when 'second' then frequency * (24.0 / period.value) * 60 * 60\n    when 'day' then frequency * (24.0 / period.value) / 24\n    when 'week' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    when 'hours' then frequency * (24.0 / period.value)\n    when 'minutes' then frequency * (24.0 / period.value) * 60\n    when 'seconds' then frequency * (24.0 / period.value) * 60 * 60\n    when 'days' then frequency * (24.0 / period.value) / 24\n    when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)\n    when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */\n    when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */\n    else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)\n  end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 48
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToInteger"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToInteger(value integer): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 49
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value MedicationRequestStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 50
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value MedicationRequestIntent): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 51
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ServiceRequestStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 52
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ProcedureStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 53
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "USCoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "ethnicity"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function ethnicity(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n    return {\n      ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 54
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "ext"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n  singleton from element.exts(url)"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 55
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "exts"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n  element.extension E\n    where E.url = url\n    return E"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 56
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "prevalenceInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n  or condition.clinicalStatus ~ \"recurrence\"\n  or condition.clinicalStatus ~ \"relapse\" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n  (end of condition.abatementInterval()) abatementDate\n    return \n\t  if abatementDate is null then\n        Interval[start of condition.onset.toInterval(), abatementDate)\n      else\n        Interval[start of condition.onset.toInterval(), abatementDate]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 57
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "abatementInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf 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\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n  if condition.abatement is FHIR.dateTime then\n    Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n  else if condition.abatement is FHIR.Period then\n    FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n  else if condition.abatement is FHIR.string then\n    Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n  else if condition.abatement is FHIR.Age then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n  else if condition.abatement is FHIR.Range then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n  else if condition.abatement is FHIR.boolean then\n    Interval[end of condition.onset.toInterval(), condition.recordedDate)\n  else \n    null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 58
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "USCoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "race"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function race(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n    return {\n      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 59
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            }
          ],
          "name" : "EffectiveDataRequirements",
          "status" : "active",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/library-type",
                "code" : "module-definition"
              }
            ]
          },
          "relatedArtifact" : [
            {
              "type" : "depends-on",
              "display" : "USQualityCore model information",
              "resource" : "https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild"
            },
            {
              "type" : "depends-on",
              "display" : "USCore model information",
              "resource" : "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"
            },
            {
              "type" : "depends-on",
              "display" : "FHIR model information",
              "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
            },
            {
              "type" : "depends-on",
              "display" : "Library SDE",
              "resource" : "https://madie.cms.gov/Library/SupplementalDataElements|6.1.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library FHIRHelpers",
              "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
            },
            {
              "type" : "depends-on",
              "display" : "Library USCommon",
              "resource" : "http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot"
            },
            {
              "type" : "depends-on",
              "display" : "Library FHIRCommon",
              "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0"
            },
            {
              "type" : "depends-on",
              "display" : "Library CMD",
              "resource" : "http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot"
            },
            {
              "type" : "depends-on",
              "display" : "Code system SNOMEDCT",
              "resource" : "http://snomed.info/sct"
            },
            {
              "type" : "depends-on",
              "display" : "Code system LOINC",
              "resource" : "http://loinc.org"
            },
            {
              "type" : "depends-on",
              "display" : "Code system ConditionClinicalStatusCodes",
              "resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Encounter to Screen for Depression",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1916"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Physical Therapy Evaluation",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Telephone Visits",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Adolescent Depression Medications",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1567"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Referral for Adolescent Depression",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1570"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Follow Up for Adolescent Depression",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1569"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Adult Depression Medications",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1566"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Referral for Adult Depression",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1571"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Follow Up for Adult Depression",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1568"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Payer Type",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Bipolar Disorder",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128"
            }
          ],
          "parameter" : [
            {
              "name" : "Measurement Period",
              "use" : "in",
              "min" : 0,
              "max" : "1",
              "type" : "Period"
            },
            {
              "name" : "ErrorLevel",
              "use" : "in",
              "min" : 0,
              "max" : "1",
              "type" : "string"
            },
            {
              "name" : "SDE Sex",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "Coding"
            },
            {
              "name" : "Numerator",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Denominator",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Payer",
              "use" : "out",
              "min" : 0,
              "max" : "*",
              "type" : "Resource"
            },
            {
              "name" : "Initial Population",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Ethnicity",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "Resource"
            },
            {
              "name" : "Denominator Exclusions",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Race",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "Resource"
            },
            {
              "name" : "Denominator Exceptions",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            }
          ],
          "dataRequirement" : [
            {
              "type" : "Patient",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient"
              ],
              "mustSupport" : [
                "ombCategory",
                "detailed",
                "text"
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1916"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"
                }
              ]
            },
            {
              "type" : "Patient",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
              ],
              "mustSupport" : [
                "birthDate"
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment"
              ],
              "mustSupport" : [
                "code",
                "effective",
                "value",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "73831-0",
                      "display" : "Adolescent depression screening assessment"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment"
              ],
              "mustSupport" : [
                "code",
                "effective",
                "value",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "73832-8",
                      "display" : "Adult depression screening assessment"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment"
              ],
              "mustSupport" : [
                "effective",
                "value"
              ]
            },
            {
              "type" : "Medication",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medication"
              ],
              "mustSupport" : [
                "id",
                "code"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1567"
                }
              ]
            },
            {
              "type" : "Medication",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medication"
              ],
              "mustSupport" : [
                "id",
                "code"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1566"
                }
              ]
            },
            {
              "type" : "MedicationRequest",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest"
              ],
              "mustSupport" : [
                "medication",
                "status",
                "intent"
              ],
              "codeFilter" : [
                {
                  "path" : "medication",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1567"
                }
              ]
            },
            {
              "type" : "MedicationRequest",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest"
              ],
              "mustSupport" : [
                "medication.reference",
                "status",
                "intent"
              ]
            },
            {
              "type" : "MedicationRequest",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest"
              ],
              "mustSupport" : [
                "medication",
                "status",
                "intent"
              ],
              "codeFilter" : [
                {
                  "path" : "medication",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1566"
                }
              ]
            },
            {
              "type" : "ServiceRequest",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest"
              ],
              "mustSupport" : [
                "code",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1570"
                }
              ]
            },
            {
              "type" : "ServiceRequest",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest"
              ],
              "mustSupport" : [
                "code",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1571"
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure"
              ],
              "mustSupport" : [
                "code",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1569"
                },
                {
                  "path" : "status",
                  "code" : [
                    {
                      "code" : "completed"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure"
              ],
              "mustSupport" : [
                "code",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1568"
                },
                {
                  "path" : "status",
                  "code" : [
                    {
                      "code" : "completed"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Coverage",
              "profile" : [
                "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage"
              ],
              "mustSupport" : [
                "type",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
                }
              ]
            },
            {
              "type" : "Condition",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
              ],
              "mustSupport" : [
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        {
          "extension" : [
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              "valueString" : "Follow-Up Plan"
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              "valueMarkdown" : "Documented follow-up for a positive depression screening must include one or more of the following:\n\n* Referral to a provider for additional evaluation and assessment to formulate a follow-up plan for a positive depression screen\n\n* Pharmacological interventions (prescribed or active depression medication)\n\n* Other interventions or follow-up for the diagnosis or treatment of depression\n\n"
            }
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              "valueString" : "Standardized Depression Screening Tool"
            },
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              "valueMarkdown" : "A normalized and validated depression screening tool developed for the patient population in which it is being utilized. Examples of standardized depression screening tools include but are not limited to:\n\n* Adolescent Screening Tools (12-17 years)\n\n  * Patient Health Questionnaire for Adolescents (PHQ-A)\n\n  * Beck Depression Inventory-Primary Care Version (BDI-PC)\n\n  * Mood Feeling Questionnaire (MFQ)\n\n  * Center for Epidemiologic Studies Depression Scale (CES-D)\n\n  * Patient Health Questionnaire (PHQ-9)\n\n  * Pediatric Symptom Checklist (PSC-17)\n\n  * Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ-2)\n\n* Adult Screening Tools (18 years and older)\n\n  * Patient Health Questionnaire (PHQ-9)\n\n  * Beck Depression Inventory (BDI or BDI-II)\n\n  * Center for Epidemiologic Studies Depression Scale (CES-D)\n\n  * Depression Scale (DEPS)\n\n  * Duke Anxiety-Depression Scale (DADS)\n\n  * Geriatric Depression Scale (GDS)\n\n  * Cornell Scale for Depression in Dementia (CSDD)\n\n  * PRIME MD-PHQ-2\n\n  * Hamilton Rating Scale for Depression (HAM-D)\n\n  * Quick Inventory of Depressive Symptomatology Self-Report (QID-SR)\n\n  * Computerized Adaptive Testing Depression Inventory (CAT-DI)\n\n  * Computerized Adaptive Diagnostic Screener (CAD-MDD)\n\n* Perinatal Screening Tools\n\n  * Edinburgh Postnatal Depression Scale\n\n  * Postpartum Depression Screening Scale\n\n  * Patient Health Questionnaire 9 (PHQ-9)\n\n  * Beck Depression Inventory\n\n  * Beck Depression Inventory-II\n\n  * Center for Epidemiologic Studies Depression Scale\n\n  * Zung Self-rating Depression Scale\n\n"
            }
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      "version" : "1.1.000",
      "name" : "CMS2FHIRPCSDepScreenAndFollowUp",
      "title" : "Preventive Care and Screening: Screening for Depression and Follow-Up PlanFHIR\n",
      "status" : "active",
      "experimental" : false,
      "date" : "2026-01-16T18:18:13+00:00",
      "publisher" : "Centers for Medicare &amp; Medicaid Services (CMS)",
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      "description" : "Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter\n",
      "usage" : "The intent of the measure is to screen all patients for depression except those with previous diagnosis of bipolar disorder. Patients who have ever been diagnosed with bipolar disorder prior to the qualifying encounter will be excluded from the measure regardless of whether the diagnosis is active or not. A depression screen is completed on the date of the encounter or up to 14 calendar days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan must be documented on the date of or up to two calendar days after the date of the encounter, such as referral to a provider for additional evaluation, pharmacological interventions, or other interventions for the treatment of depression. An example to illustrate the follow-up plan documentation timing: if the encounter is on a Monday from 3-4 pm (day 0) and the patient screens positive, the clinician has through anytime on Wednesday (day 2) to complete follow-up plan documentation. This measure does not require documentation of a specific score, just whether results of the normalized and validated depression screening tool used are considered positive or negative. Each standardized screening tool provides guidance on whether a particular score is considered positive for depression. The measure is not prescriptive in the specific screening tool being used and provides no hierarchy for acceptance of one tool over another. In the case where two screenings are documented on the same date/time with different results (one positive and one negative), the measure only assesses the most recent screening. Since both screenings are both considered the most recent, the patient will be captured in the numerator if the positive screening result also includes documentation of an intervention following the positive screen. This eCQM is a patient-based measure. Depression screening is required once per measurement period, not at all encounters. Screening Tools:\n\n* An age-appropriate, standardized, and validated depression screening tool must be used for numerator compliance.\n\n* The name of the age-appropriate standardized depression screening tool utilized must be documented in the medical record.\n\n* The depression screening must be reviewed and addressed by the provider, filing the code, on the date of the encounter. Positive pre-screening results indicating a patient is at high risk for self-harm should receive more urgent intervention as determined by the provider practice.\n\n* The screening should occur during a qualifying encounter or up to 14 calendar days prior to the date of the qualifying encounter.\n\n* The measure assesses the most recent depression screening completed either during the qualifying encounter or within the 14 calendar days prior to that encounter. Therefore, a clinician would not be able to complete another screening at the time of the encounter to count towards a follow-up, because that would serve as the most recent screening. In order to satisfy the follow-up requirement for a patient screening positively, the eligible clinician would need to provide one of the aforementioned follow-up actions, which does not include use of a standardized depression screening tool.\n\nFollow-Up Plan:\n\nWhile there are many validated depression screening tools, they are not necessarily diagnostic tools. Patients with elevated depression screening scores should be followed by a clinician to evaluate whether a depression diagnosis is appropriate, but a medication and/or referral are not always indicated for a positive score. In these cases, a follow up plan is appropriate.\n\nThe follow-up plan MUST still be provided for and discussed with the patient during the qualifying encounter used to evaluate the numerator. However, documentation of the follow-up plan can occur up to two calendar days after the qualifying encounter, in accordance with the policies of an eligible clinician or provider's practice or health system. All services should be documented during, or as soon as practicable, after the qualifying encounter in order to maintain an accurate medical record.\n\nExamples of a follow-up plan include but are not limited to:\n\n* Referral to a provider or program for further evaluation for depression, for example, referral to a psychiatrist, psychiatric nurse practitioner, psychologist, clinical social worker, mental health counselor, or other mental health service such as family or group therapy, support group, depression management program, or other service for treatment of depression\n\n* Other interventions designed to treat depression such as behavioral health evaluation, psychotherapy, pharmacological interventions, or additional treatment options.\n\n* Exercise regimens, education counseling, coping support, and completion of a mental health crisis plan.\n\nShould a patient screen positive for depression, a clinician should:\n\n* Only order pharmacological intervention when appropriate and after sufficient diagnostic evaluation. However, for the purposes of this measure, additional screening and assessment during the qualifying encounter will not qualify as a follow-up plan.\n\n* Opt to complete a suicide risk assessment when appropriate and based on individual patient characteristics. However, for the purposes of this measure, a suicide risk assessment or an additional screening using a standardized tool will not qualify as a follow-up plan.\n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS2v15. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6.0.0 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n",
      "copyright" : "This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare \\& Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications.\n\nLimited 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. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-2024 International Health Terminology Standards Development Organization. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.\n",
      "effectivePeriod" : {
        "start" : "2026-01-01",
        "end" : "2026-12-31"
      },
      "author" : [
        {
          "name" : "American Institutes for Research (AIR)",
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              "value" : "https://www.air.org"
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      ],
      "relatedArtifact" : [
        {
          "type" : "citation",
          "citation" : "American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. (2018). ACOG Committee Opinion Number 757: Screening for perinatal depression. Obstetrics and Gynecology, 132(5), e208-e212. doi: 10.1097/AOG.0000000000002927\n"
        },
        {
          "type" : "citation",
          "citation" : "American Psychiatric Association. (2017). Mental Health Disparities: Diverse Populations. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts\n"
        },
        {
          "type" : "citation",
          "citation" : "Anderson, J., Michalak, E., \\& Lam, R. (2002). Depression in primary care: Tools for screening, diagnosis, and measuring response to treatment. BCMJ, 44(8),415-419. https://bcmj.org/articles/depression-primary-care-tools-screening-diagnosis-and-measuring-response-treatment\n"
        },
        {
          "type" : "citation",
          "citation" : "Borner, I., Braunstein, J. W., St. Victor, R., \\& Pollack, J. (2010). Evaluation of a 2-question screening tool for detecting depression in adolescents in primary care. Clinical Pediatrics, 49(10), 947-995. doi:10.1177/0009922810370203\n"
        },
        {
          "type" : "citation",
          "citation" : "Chen, T., Huang, F., Chang, C., \\& Chung, H. (2006), Using the PHQ-9 for depression screening and treatment monitoring for Chinese Americans in primary care. Psychiatr Serv., 57(7),976--981. https://ps.psychiatryonline.org/doi/full/10.1176/ps.2006.57.7.976\n"
        },
        {
          "type" : "citation",
          "citation" : "Costantini, L., Costanza, A., Odone, A., Aguglia, A., Escelsior, A., Serafini, G., Amore, M., \\& Amerio, A. (2021). A breakthrough in research on depression screening: from validation to efficacy studies. Acta bio-medica : Atenei Parmensis, 92(3), e2021215. https://doi.org/10.23750/abm.v92i3.11574\n"
        },
        {
          "type" : "citation",
          "citation" : "Dadi, A. F., Miller, E. R., Bisetegn, T. A., \\& Mwanri, L. (2020). Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC public health, 20(1), 173. https://doi.org/10.1186/s12889-020-8293-9\n"
        },
        {
          "type" : "citation",
          "citation" : "Hazell Raine, K., Nath, S., Howard, L. M., Cockshaw, W., Boyce, P., Sawyer, E., \\& Thorpe, K. (2020). Associations between prenatal maternal mental health indices and mother-infant relationship quality 6 to 18 months' postpartum: A systematic review. Infant mental health journal, 41(1), 24--39. https://doi.org/10.1002/imhj.21825\n"
        },
        {
          "type" : "citation",
          "citation" : "Ka'apu, K., \\& Burnette, C. E. (2019). A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?. British journal of social work, 49(4), 880--898. https://doi.org/10.1093/bjsw/bcz009\n"
        },
        {
          "type" : "citation",
          "citation" : "Lee, S. Y., Xue, Q. L., Spira, A. P., \\& Lee, H. B. (2014). Racial and ethnic differences in depressive subtypes and access to mental health care in the United States. Journal of affective disorders, 155, 130--137. https://doi.org/10.1016/j.jad.2013.10.037\n"
        },
        {
          "type" : "citation",
          "citation" : "Orhurhu, V., Olusunmade, M., Akinola, Y., Urits, I., Orhurhu, M. S., Viswanath, O., ... Gill, J. S. (2019). Depression Trends in Patients with Chronic Pain: An Analysis of the Nationwide Inpatient Sample. Pain physician, 22(5), E487--E494.\n"
        },
        {
          "type" : "citation",
          "citation" : "Siu, A. L., \\& USPSTF. (2016). Screening for depression in adults: U.S. Preventive Services Task Force recommendation statement. Journal of the American Medical Association, 315(4), 380-387. doi:10.1001/jama.2015.18392.\n"
        },
        {
          "type" : "citation",
          "citation" : "Siu, A. L., on behalf of USPSTF. (2016). Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 164(5), 360-366. doi:10.7326/M15-2957\n"
        },
        {
          "type" : "citation",
          "citation" : "Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19 5068, NSDUH Series H 54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.htm#mde\n"
        },
        {
          "type" : "citation",
          "citation" : "Trangle, M., Gursky, J., Haight, R., Hardwig, J., Hinnenkamp, T., Kessler, D.,... Myszkowski, M. (2016). Adult depression in primary care. Bloomington, MN: Institute for Clinical Systems Improvement. Retrieved from https://www.icsi.org/guideline/depression/\n"
        },
        {
          "type" : "citation",
          "citation" : "U.S. Department of Health and Human Services. (2020). Healthy People 2030: Depression in adults: Screening. Washington, DC: U.S. Department of Health and Human Services. Retrieved from https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/depression-adults-screening\n"
        },
        {
          "type" : "citation",
          "citation" : "U.S. Preventive Services Task Force. (2016). Final recommendation statement: depression in adults: screening. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/depression-in-adults-screening\n"
        },
        {
          "type" : "citation",
          "citation" : "U.S. Preventive Services Task Force. (2019). Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement. JAMA, 321(6):580--587. doi:10.1001/jama.2019.0007\n"
        },
        {
          "type" : "citation",
          "citation" : "Vibhakar, V., Allen, L. R., Gee, B., \\& Meiser-Stedman, R. (2019). A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma. Journal of affective disorders, 255, 77--89. https://doi.org/10.1016/j.jad.2019.05.005\n"
        }
      ],
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        🔗 "https://madie.cms.gov/Library/CMS2FHIRPCSDepScreenAndFollowUp"
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      "disclaimer" : "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\] and unregistered trademarks are indicated by (TM) or \\[TM\\].\n",
      "rationale" : "Depression affects more than two hundred sixty million people across the world and is a leading cause of disability, with a variety of depressive disorders that are independent risk factors for chronic diseases, such as cardiovascular disease and diabetes, lending screening for depression as paramount to identify depressive disorders that can affect the most vulnerable populations (Costantini et al., 2021). Results from a 2018 U.S. survey indicated that 14.4 percent of adolescents (3.5 million adolescents) had a major depressive episode (MDE) in the past year, with nine percent of adolescents (2.4 million adolescents) having one MDE with severe impairment (Substance Abuse and Mental Health Services Administration, 2019). The odds of a diagnosis of depression are believed to be 2.6 times greater for children and adolescents exposed to trauma as compared to those unexposed or less exposed (Vibhakar et al., 2019). Children and teens with major depressive disorder (MDD) have been found to have difficulty carrying out their daily activities, relating to others, growing up healthy, and are at an increased risk of suicide (Siu on behalf of the U.S. Preventive Services Task Force \\[USPSTF\\], 2016).\n\nThe same 2018 study indicated that 7.2 percent of adults aged 18 or older (17.7 million adults) had at least one MDE with 4.7 percent of adults (11.5 million adults) having one MDE with severe impairment in the past year (Substance Abuse and Mental Health Services Administration, 2019). Moreover, it is estimated 22.9 percent of adult patients with chronic pain (2.2 million adults) were diagnosed with comorbid depression from 2011 to 2015, with an upward trend of prevalence among Black Americans, patients aged 65 to 84 years old, Medicare and Medicaid insured patients, and patients from zip code areas with low annual household incomes (Orhurhu et al., 2019).\n\nDepression and other mood disorders, such as bipolar disorder and anxiety disorders, especially during the perinatal period, can have devastating effects on women, infants, and families (American College of Obstetricians and Gynecologists, 2018). It's estimated that the global prevalence of antenatal (or perinatal) depression ranges from 15 to 65 percent, with current or previous exposure to abuse and violence, lack of social support, and family history of mental disorders being risk factors. Depressive symptoms measured during pregnancy have been shown to influence the quality of the postpartum mother-infant relationship (Hazell Raine et al., 2020). Additionally, the risk of low birth weight and preterm birth is higher among infants born from depressed mothers (Dadi, Miller, Bisetegn, \\& Mwanri, 2020).\n\nNegative outcomes associated with depression make it crucial to screen in order to identify and treat depression in its early stages. Multiple social costs of depression have been identified, such as reduced educational achievements, poor financial success and role performance, higher amount of days out of role, and increased risk of job loss (Costantini et al., 2021). Depression also imposes significant economic burden through direct and indirect costs, supporting the need for regular depression screening. \"In the United States, an estimated $22.8 billion was spent on depression treatment in 2009, and lost productivity cost an additional estimated $23 billion in 2011\" (Siu \\& USPSTF, 2016, p. 383-384).\n\nNumerous studies have found significant disparities in depression prevalence and treatment among racial/ethnic minorities. One study revealed that Indigenous adults are at a high risk for posttraumatic stress disorder, depression, suicide, substance use disorder, and concurrent behavioral health disorders secondary to these initial health problems (Ka'apu and Burnette, 2019). Additionally, though rates of depression are lower among Blacks and Hispanics than among whites, depression among Blacks and Hispanics is likely to be more recurrent. Furthermore, 48 percent of whites receive mental health services, compared to just 31 percent of Blacks and Hispanics, and 22 percent of Asians (American Psychiatric Association, 2017). Asian Americans and Black Americans are also significantly more likely to utilize emergency rooms for depression treatment, which contributes to inconsistent follow-up care (Lee et al., 2014).\n\nWhile primary care providers (PCPs) serve as the first line of defense in the detection of depression, studies show that PCPs fail to recognize up to 46 percent of depressed patients (Borner et al., 2010). \"In nationally representative U.S. surveys, about eight percent of adolescents reported having major depression in the past year. Only 36 percent to 44 percent of children and adolescents with depression receive treatment, suggesting that a majority of depressed youth are undiagnosed and untreated\" (Siu on behalf of USPSTF, 2016). Furthermore, evidence supports that screening for depression in pregnant and postpartum women is of moderate net benefit, and treatment options for positive depression screening should be available for patients twelve and older including pregnant and postpartum women.\n\nThis measure seeks to align with USPSTF clinical guideline recommendations as well as the Healthy People 2030 recommendation to increase the proportion of adolescents and adults who are screened for depression and if positive, receive appropriate treatment (U.S. Preventive Services Task Force, 2016; U.S. Department of Health and Human Services, 2020).\n\nFor patients with depression, rescreening has been shown to be an effective tool for measuring response to therapy, therefore influencing appropriate care adjustments in the treatment of depression (Anderson et al., 2002). Chen et al. noted that when patients were re-administered a screening tool after at least eight weeks after starting treatment, their \"score gave primary care physicians a clear idea about the nature of patients' depressive symptoms and gave both the patient and the physician an indication of treatment progress\" (Chen et al., 2006).\n",
      "clinicalRecommendationStatement" : "Adolescent Recommendation (12-18 years):\n\n\"The USPSTF recommends screening for MDD in adolescents aged 12 to 18 years. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up (B recommendation)\" (Siu on behalf of USPSTF, 2016).\n\nAdult Recommendation (18 years and older):\n\n\"The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up (B recommendation)\" (Siu \\& USPSTF, 2016).\n\n\"The USPSTF recommends that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions (B recommendation)\" (U.S. Preventive Services Task Force, 2019).\n\nThe American College of Obstetricians and Gynecologists (ACOG) provides the following recommendation: \"All obstetrician--gynecologists and other obstetric care providers should complete a full assessment of mood and emotional well-being (including screening for postpartum depression and anxiety with a validated instrument) during the comprehensive postpartum visit for each patient\" (American College of Obstetricians and Gynecologists, 2018).\n\nThe Institute for Clinical Systems Improvement (ICSI) health care guideline, Adult Depression in Primary Care, provides the following recommendations:\n\n1. \"Clinicians should routinely screen all adults for depression using a standardized instrument.\"\n\n2. \"Clinicians should establish and maintain follow-up with patients.\"\n\n3. \"Clinicians should screen and monitor depression in pregnant and post-partum women\" (Trangle et al., 2016).\n\n",
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                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "increase",
                    "display" : "Increased score indicates improvement"
                  }
                ]
              }
            }
          ],
          "description" : "Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter\n",
          "population" : [
            {
              "id" : "InitialPopulation_1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "All patients aged 12 years and older at the beginning of the measurement period with at least one qualifying encounter during the measurement period\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "Denominator_1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Equals Initial Population\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "DenominatorExclusion_1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator-exclusion",
                    "display" : "Denominator Exclusion"
                  }
                ]
              },
              "description" : "Patients who have ever been diagnosed with bipolar disorder at any time prior to the qualifying encounter\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exclusions"
              }
            },
            {
              "id" : "Numerator_1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Patients screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter or an active depression medication overlaps the date of the qualifying encounter\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator"
              }
            },
            {
              "id" : "DenominatorException_1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator-exception",
                    "display" : "Denominator Exception"
                  }
                ]
              },
              "description" : "Patient Reason(s) - Patient refuses to participate in or complete the depression screening\n\nOR\n\nMedical Reason(s) - Documentation of medical reason for not screening patient for depression (e.g., cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status)\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exceptions"
              }
            }
          ]
        }
      ],
      "supplementalData" : [
        {
          "id" : "sde-ethnicity",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Ethnicity\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Ethnicity"
          }
        },
        {
          "id" : "sde-payer",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Payer\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Payer"
          }
        },
        {
          "id" : "sde-race",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Race\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Race"
          }
        },
        {
          "id" : "sde-sex",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Sex\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Sex"
          }
        }
      ]
    }