dQM QICore Content Implementation Guide
2025.0.0 - CI Build

dQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-qicore-2025/ and changes regularly. See the Directory of published versions

Library: CMS771FHIRUrinarySymptomScoreBPH

Official URL: https://madie.cms.gov/Library/CMS771FHIRUrinarySymptomScoreBPH Version: 1.0.000
Active as of 2025-08-22 Responsible: Large Urology Group Practice Association (LUGPA) Computable Name: CMS771FHIRUrinarySymptomScoreBPH
Other Identifiers: https://madie.cms.gov/login#CMS771FHIRUrinarySymptomScoreBPH (use: official, )

CMS771FHIRUrinarySymptomScoreBPH

Metadata
Title CMS771FHIRUrinarySymptomScoreBPH
Version 1.0.000
Identifier CMS771FHIRUrinarySymptomScoreBPH
Steward (Publisher) Large Urology Group Practice Association (LUGPA)
Description

CMS771FHIRUrinarySymptomScoreBPH

Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Patient
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Patient is Male
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Qualifying Encounter
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Has Qualifying BPH Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Documented IPSS Assessment Result
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: AUA Symptom Index and Quality of Life Assessment Result
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Urinary Symptom Score Assessment
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Morbid Obesity Diagnosis On or Before Follow Up USS Assessment
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator Exclusions
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Urinary Symptom Score Change
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: integer
Parameter Name: Urinary Symptom Score Improvement Greater Than or Equal To 3
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Ethnicity
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Payer
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: SDE Race
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Sex
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, class, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) N40.1: Benign prostatic hyperplasia with lower urinary tract symptoms
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) N40.1: Benign prostatic hyperplasia with lower urinary tract symptoms
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, effective, status, status.value, value
Code Filter(s):
Path: code
Code(s): LOINC 80883-2: American Urological Association Symptom Index [AUASI]
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, effective, status, status.value, value
Code Filter(s):
Path: code
Code(s): LOINC 81090-3: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, status, status.value, value, effective
Code Filter(s):
Path: code
Code(s): LOINC 80976-4: International Prostate Symptom Score [IPSS]
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
Must Support Elements: value, status, status.value, effective
Library Content
CQL Content
library CMS771FHIRUrinarySymptomScoreBPH version '1.0.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers
include SupplementalDataElements version '5.1.000' called SDE
include QICoreCommon version '4.0.000' called QICoreCommon

codesystem "LOINC": 'http://loinc.org'
codesystem "ICD10CM": 'http://hl7.org/fhir/sid/icd-10-cm'
codesystem "ActCode": 'http://terminology.hl7.org/CodeSystem/v3-ActCode'

valueset "Hospital Services for Urology Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360'
valueset "Morbid Obesity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Urinary Retention": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372'

code "American Urological Association Symptom Index [AUASI]": '80883-2' from "LOINC" display 'American Urological Association Symptom Index [AUASI]'
code "Benign prostatic hyperplasia with lower urinary tract symptoms": 'N40.1' from "ICD10CM" display 'Benign prostatic hyperplasia with lower urinary tract symptoms'
code "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]": '81090-3' from "LOINC" display 'If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]'
code "International Prostate Symptom Score [IPSS]": '80976-4' from "LOINC" display 'International Prostate Symptom Score [IPSS]'
code "virtual": 'VR' from "ActCode" display 'virtual'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "Initial Population":
  ( "Patient is Male" )
    and "Has Qualifying Encounter"
    and "Has Qualifying BPH Diagnosis"

define "Denominator":
  "Initial Population"
    and "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" is not null
    and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" is not null

define "Denominator Exclusions":
  exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )
    or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )
    or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )

define "Numerator":
  "Urinary Symptom Score Improvement Greater Than or Equal To 3"

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Payer":
  SDE."SDE Payer"

define "SDE Race":
  SDE."SDE Race"

define "SDE Sex":
  SDE."SDE Sex"

define "Has Qualifying BPH Diagnosis":
  "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" is not null

define "Patient is Male":
  SDE."SDE Sex" ~ SDE."Male (finding)"

define "Urinary Symptom Score Assessment":
  "Documented IPSS Assessment Result"
    union "AUA Symptom Index and Quality of Life Assessment Result"

define "Urinary Symptom Score Change":
  from
    "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" FirstUSSAssessment,
    "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
    let USSChange: ( FirstUSSAssessment.valueInteger ) - ( FollowUpUSSAssessment.valueInteger )
    return USSChange

define "Urinary Symptom Score Improvement Greater Than or Equal To 3":
  ( "Urinary Symptom Score Change" USSImprovement
      where USSImprovement >= 3
  ) is not null

define "Documented IPSS Assessment Result":
  [ObservationScreeningAssessment: "International Prostate Symptom Score [IPSS]"] IPSSAssessment
    where IPSSAssessment.status in { 'final', 'amended', 'corrected' }
      and IPSSAssessment.value is not null
    return {
      effectiveDatetime: IPSSAssessment.effective.earliest ( ),
      valueInteger: IPSSAssessment.value as Integer
    }

define "AUA Symptom Index and Quality of Life Assessment Result":
  [ObservationScreeningAssessment: "American Urological Association Symptom Index [AUASI]"] AUASIAssessment
    let LastQOLOnDate: Last([ObservationScreeningAssessment: "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"] QOLAssessment
        where QOLAssessment.effective.earliest() same day as AUASIAssessment.effective.earliest()
          and QOLAssessment.status in { 'final', 'amended', 'corrected' }
          and QOLAssessment.value is not null
        sort by effective.earliest()
    )
    where AUASIAssessment.status in { 'final', 'amended', 'corrected' }
      and AUASIAssessment.value is not null
    return {
      effectiveDatetime: AUASIAssessment.effective.earliest ( ),
      valueInteger: ( AUASIAssessment.value as Integer ) + ( LastQOLOnDate.value as Integer )
    }

define "Has Qualifying Encounter":
  exists ( [Encounter: "Office Visit"] ValidEncounter
      where ValidEncounter.period during day of "Measurement Period"
        and ValidEncounter.class !~ "virtual"
        and ValidEncounter.status = 'finished'
  )

define "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment":
  exists "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"
    or "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"

define "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis":
  ( [ConditionProblemsHealthConcerns: "Urinary Retention"]
    union [ConditionEncounterDiagnosis: "Urinary Retention"] ) UrinaryRetention
    with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
      such that UrinaryRetention.prevalenceInterval ( ) starts 1 year or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval ( )
    where UrinaryRetention.verificationStatusIsNotInvalid ( )

define "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis":
  Last("Urinary Symptom Score Assessment" USSAssessment
      with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
        such that difference in months between start of InitialBPHDiagnosis.prevalenceInterval() and USSAssessment.effectiveDatetime in Interval[6, 12]
      sort by effectiveDatetime
  )

define "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis":
  First("Urinary Symptom Score Assessment" USSAssessment
      with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
        such that USSAssessment.effectiveDatetime 1 month or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval()
      sort by effectiveDatetime
  )

define "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization":
  "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
    with [Encounter: "Hospital Services for Urology Care"] UrologyHospitalServices
      such that InitialBPHDiagnosis.prevalenceInterval ( ) starts during Interval[start of UrologyHospitalServices.period, end of UrologyHospitalServices.period + 31 days]
        and UrologyHospitalServices.status = 'finished'

define "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period":
  First(([ConditionProblemsHealthConcerns: "Benign prostatic hyperplasia with lower urinary tract symptoms"]
      union [ConditionEncounterDiagnosis: "Benign prostatic hyperplasia with lower urinary tract symptoms"]) NewBPHDiagnosis
      where NewBPHDiagnosis.prevalenceInterval() starts during Interval[start of "Measurement Period" - 6 months, start of "Measurement Period"]
        and NewBPHDiagnosis.verificationStatusIsNotInvalid()
      sort by start of onset.toInterval()
  )

define "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment":
  ( [ConditionProblemsHealthConcerns: "Morbid Obesity"]
    union [ConditionEncounterDiagnosis: "Morbid Obesity"] ) MorbidObesityDiagnosis
    with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
      such that MorbidObesityDiagnosis.prevalenceInterval ( ) overlaps "Measurement Period"
        and MorbidObesityDiagnosis.prevalenceInterval ( ) starts on or before FollowUpUSSAssessment.effectiveDatetime
    where MorbidObesityDiagnosis.verificationStatusIsNotInvalid ( )  
  
/*
* @code: Body mass index (BMI) [Ratio] - 39156-5
* @profile: http://hl7.org/fhir/StructureDefinition/bmi
*/


define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment":
  exists ( ["USCoreBMIProfile"] BMIExam
      with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
        such that BMIExam.value >= 40 'kg/m2'
          and BMIExam.status in { 'final', 'amended', 'corrected' }
          and BMIExam.effective.earliest ( ) during day of "Measurement Period"
          and BMIExam.effective.earliest ( ) on or before FollowUpUSSAssessment.effectiveDatetime
      return BMIExam.effective.earliest ( )
  )

define fluent function verificationStatusIsNotInvalid(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
  condition.verificationStatus is null
    or not ( condition.verificationStatus ~ QICoreCommon."unconfirmed"
        or condition.verificationStatus ~ QICoreCommon."refuted"
        or condition.verificationStatus ~ QICoreCommon."entered-in-error"
    )
ELM XML Content
Encoded data (249684 characters)
ELM JSON Content
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