dQM QICore Content Implementation Guide
2025.0.0 - CI Build
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
| Active as of 2025-08-21 |
<Measure xmlns="http://hl7.org/fhir">
<id value="CMS1154ScreeningPrediabetesFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" class="col-12">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header">Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">1.0.000</td>
</tr>
<tr>
<th scope="row" class="row-header">Short Name</th>
<td class="content-container">CMS1154FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:d5fabe20-5aaa-4dea-bfb4-2fde59ea40d6</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:c116e4ae-6daf-49b2-b415-dd229215c674</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">1154FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2026-01-01 through 2026-12-31</td>
</tr>
<tr>
<th scope="row" class="row-header">Use Context</th>
<td class="content-container">org.hl7.fhir.r5.model.UsageContext@5f13e610</td>
</tr>
<tr>
<th scope="row" class="row-header">Steward (Publisher)</th>
<td class="content-container">American Medical Association (AMA)</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">American Medical Association (AMA)</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">Health Services Advisory Group</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container"><p>Percentage of adult patients with risk factors for type 2 diabetes who are due for glycemic screening for whom the screening process was completed during the measurement period.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container"><p>Prediabetes Quality Measures (C) 2018-2025. American Medical Association. All rights reserved.</p>
<p>CPT (R) 2025 American Medical Association (“AMA”). All rights reserved. You cannot, without express written permission from the AMA, copy, modify, distribute, display, or use CPT for any commercial purpose, including for productive use in a clinical setting. Any such use requires a separate license from the AMA.</p>
<p>You agree that you shall not remove, obscure, or alter any proprietary rights notices (including copyright and trademark notices) which may be affixed to or contained within the measure.</p>
<p>Current Procedural Terminology (CPT [R] code(s) (“CPT Codes”) information provided in the Measures is intended for reference and informational purposes only. Decisions regarding which CPT Code is appropriate must be made by physicians and/or their staff considering the clinical facts, circumstances, applicable coding and published AMA coding guideline and payor policies. The AMA does not dictate payer reimbursement policy and does not substitute for the professional judgment of the practitioner performing a procedure, who remains responsible for correct coding. The AMA is not engaged in the practice of medicine or dispensing medical services. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of the CPT code set, and the AMA is not recommending their use.</p>
<p>Information contained in the measure includes information protected by intellectual property rights which are owned by the AMA. The Measures may also contain proprietary code sets not owned by the AMA. The AMA disclaims all liability for the use or accuracy of any such information. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC [R] copyright 2004-2025 Regenstrief Institute, Inc., SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2025, The International Health Information Standards Development Organisation (IHTSDO). ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Disclaimer</th>
<td class="content-container"><p>The Prediabetes Quality Measure set descriptions and specifications (collectively, “Measures”) are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures are not intended to diagnose or treat disease or other conditions. The Measures are not a medical device and have not been evaluated by the Food and Drug Administration. Information provided through the Measures is not intended to direct or substitute for the independent assessment or judgment of a qualified healthcare professional. The American Medical Association (“AMA”) assumes no liability for use of the Measures, or data contained or not contained in the Measures.</p>
<p>The AMA consents to the use, reproduction and distribution of the Measures for non-commercial purposes only (e.g., for use by health care providers in a professional setting). You cannot, without the express written consent of the AMA, use the Measures for any commercial purpose. Unauthorized commercial use of the Measures is expressly prohibited. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed, or distributed for commercial gain. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.</p>
<p>To request to make a commercial use of the Measures, please email: AMA.IHO.QualityMeasures@ama-assn.org. Any commercial use of the Measures requires a separate license from the AMA.</p>
<p>Any use, publication or other dissemination of these Measures shall include the following attribution:</p>
<p>“This [publication, etc.] was prepared using clinical quality measures developed by the American Medical Association. The content reflects the views of [name of author(s)].”</p>
<p>USE OF THE MEASURES (INCLUDING ANY CPT CODES) IS AT YOUR SOLE RISK. THE MEASURES ARE PROVIDED “AS IS” WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT. AMA EXPRESSLY DISCLAIMS ANY AND ALL RESPONSIBILITY OR LIABILITY FOR DAMAGES OF ANY KIND ARISING OUT OF USE, REFERENCE TO, OR RELIANCE ON THE MEAUSURES.</p>
<p>These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Rationale</th>
<td class="content-container"><p>This measure is critical to identifying patients with prediabetes who may benefit from interventions to prevent type 2 diabetes and identification of undiagnosed type 2 diabetes. The Centers for Disease Control and Prevention (CDC) estimates that approximately 97.6 million American adults have prediabetes (CDC, 2024). They note that more than 80% of adults with prediabetes are not aware that they have the condition. Regular screening for prediabetes is a critical first step to helping patients avoid the disability and costs associated with progression to type 2 diabetes.</p>
<p>The measure gives credit for three types of tests that can be used to detect abnormal glucose metabolism: HbA1c, oral glucose tolerance, and fasting plasma glucose. When considering which plasma glucose screening codes to include in the measure, the measure development team carefully considered two potential unintended consequences related to the limited use of accompanying fasting status codes. If the measure specified plasma glucose screening too narrowly, it could incentivize over screening, which would impose added burden on clinicians and increased costs to some patients. Alternatively, if the measure specified plasma glucose screening too broadly, it could give credit for non-fasting plasma glucose tests that are not adequate for diagnostic purposes.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container"><p>The U.S. Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions (B recommendation) (USPSTF, 2021).</p>
<p>Evidence on the optimal screening interval for adults with an initial normal glucose test result is limited. Cohort and modeling studies suggest that screening every 3 years may be a reasonable approach for adults with normal blood glucose levels (USPSTF, 2021).</p>
<p>Prediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test. A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour post-load glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes (USPSTF, 2021).</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>Centers for Disease Control and Prevention. (2024, July 23). National Diabetes Statistics Report. Retrieved November 15, 2024, from Diabetes website: https://www.cdc.gov/diabetes/php/data-research/</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>U.S. Preventive Services Task Force. (2021). Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. JAMA, 326(8), 736–743. https://doi.org/10.1001/jama.2021.12531</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container"><p>The measure is limited to patients aged 35 to 70 with overweight or obesity because it is recommended that all patients with those risk factors be screened for diabetes at least once every three years. However, this measure is not intended to discourage screening at younger ages, which the USPSTF recommends considering for adults with overweight or obesity and any of the following risk factors:</p>
<ul>
<li>Race/ethnicity with disproportionately high incidence and prevalence of diabetes (American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons)</li>
<li>Family history of diabetes</li>
<li>History of gestational diabetes</li>
<li>History of polycystic ovarian syndrome</li>
</ul>
<p>It is recommended that every patient evaluated by this measure also identify payer, race, ethnicity, and sex.</p>
<p>This eCQM is a patient-based measure.</p>
<p>This FHIR-based measure has been derived from the QDM-based measure CMS1154v1. 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 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: InitialPopulation_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>All patients with at least two outpatient clinical encounters or one preventive clinical encounter during the measurement period who have the following risk factors for type 2 diabetes:</p>
<ul>
<li>Most recent BMI ≥25 kg/m2 (BMI ≥23 kg/m2 for Asian patients) during measurement period, AND</li>
<li>Age 35-70 at start of measurement period.</li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms1154screeningprediabetesfhir-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>All patients in the initial population.</p></p>
<em>Logic Definition</em>: <a href="#primary-cms1154screeningprediabetesfhir-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li>Patient's pregnancy overlaps measurement period.</li>
<li>Patient with diagnosis of advanced illness or limited life expectancy overlaps measurement period.</li>
<li>Patient with diagnosis of diabetes overlaps 2-year look-back period.</li>
<li>Patient with diagnosis of prediabetes overlaps 2-year look-back period.</li>
<li>Patient with glycemic screening performed during 2-year look-back period.</li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms1154screeningprediabetesfhir-denominator-exclusions">Denominator Exclusions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients who had a glycemic screening test performed during the measurement period.</p></p>
<em>Logic Definition</em>: <a href="#primary-cms1154screeningprediabetesfhir-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Guidance</th>
<td class="content-container"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex.</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-ethnicity
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Ethnicity
<br/>
<em>Logic Definition</em>: <a href="#cms1154screeningprediabetesfhir-sde-ethnicity">SDE Ethnicity</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-payer
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Payer
<br/>
<em>Logic Definition</em>: <a href="#cms1154screeningprediabetesfhir-sde-payer">SDE Payer</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-race
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Race
<br/>
<em>Logic Definition</em>: <a href="#cms1154screeningprediabetesfhir-sde-race">SDE Race</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-sex
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Sex
<br/>
<em>Logic Definition</em>: <a href="#cms1154screeningprediabetesfhir-sde-sex">SDE Sex</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container">https://madie.cms.gov/Library/CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1154screeningprediabetesfhir-initial-population"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
"Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1154screeningprediabetesfhir-denominator"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1154screeningprediabetesfhir-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Has Pregnancy Observation During Measurement Period"
or exists "Has Pregnancy Diagnosis During Measurement Period"
or exists "Has Advanced Illness or Limited Life Expectancy"
or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1154screeningprediabetesfhir-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Glycemic Laboratory Test Performed During Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tostring"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tointerval"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tocode"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-tointerval"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-glycemic-laboratory-test-performed-during-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Glycemic Laboratory Test Performed During Measurement Period":
[LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Measurement Period"
and LabTestPerformed.status in { 'final', 'amended', 'corrected' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Glycemic Laboratory Test Performed During Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-preventive-care-outpatient-visits-during-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Preventive Care Outpatient Visits During Measurement Period":
[Encounter: "Preventative Clinical Encounters"] PreventiveCare
where PreventiveCare.period ends during day of "Measurement Period"
and PreventiveCare.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-office-visit-during-the-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Office Visit During the Measurement Period":
[Encounter: "Outpatient Clinical Encounters"] OfficeVisit
where OfficeVisit.period during day of "Measurement Period"
and OfficeVisit.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-aged-35-to-70-at-start-of-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Aged 35 to 70 at Start of Measurement Period":
"AgeInYearsAt"(date from start of "Measurement Period") between 35 and 70</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-patients-aged-35-to-70-with-an-office-visit-during-the-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patients Aged 35 to 70 with an Office Visit During the Measurement Period":
( exists ( "Preventive Care Outpatient Visits During Measurement Period" )
or Count("Office Visit During the Measurement Period") >= 2
)
and "Aged 35 to 70 at Start of Measurement Period" is true</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-most-recent-bmi"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Most Recent BMI":
First([USCoreBMIProfile] BMI
where BMI.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval() desc
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-patient-is-asian"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patient is Asian":
exists ( SDE."SDE Race".codes C
where C ~ "Asian"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-patient-is-not-asian"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patient is not Asian":
not ( "Patient is Asian" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-most-recent-bmi-equal-to-or-greater-than-25-and-is-not-asian"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian":
"Most Recent BMI".value >= 25 'kg/m2'
and "Patient is not Asian"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-most-recent-bmi-equal-to-or-greater-than-23-and-is-asian"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Most Recent BMI Equal to or Greater Than 23 and Is Asian":
"Most Recent BMI".value >= 23 'kg/m2'
and "Patient is Asian"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
"Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-has-pregnancy-observation-during-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Pregnancy Observation During Measurement Period":
exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
where PregnantObservation.value in "Pregnancy"
and PregnantObservation.effective.toInterval ( ) overlaps day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-has-pregnancy-diagnosis-during-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Pregnancy Diagnosis During Measurement Period":
( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
union [ConditionEncounterDiagnosis: "Pregnancy"]
).verified ( ) ) PregnancyDx
where PregnancyDx.prevalenceInterval ( ) overlaps day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-has-advanced-illness-or-limited-life-expectancy"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Advanced Illness or Limited Life Expectancy":
( ( ["ConditionProblemsHealthConcerns": "Advanced Illness"]
union ["ConditionEncounterDiagnosis": "Advanced Illness"]
union ["ConditionProblemsHealthConcerns": "Limited Life Expectancy"]
union ["ConditionEncounterDiagnosis": "Limited Life Expectancy"]
).verified ( ) ) AdvancedIllness
where "AdvancedIllness".onset before day of end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-look-back-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Look Back Period":
Interval[start of "Measurement Period" - 2 years, start of "Measurement Period" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-diabetes-diagnosis-overlaps-2-year-look-back-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Diabetes Diagnosis Overlaps 2 Year Look Back Period":
( ( ["ConditionProblemsHealthConcerns": "Diabetes"]
union [ConditionEncounterDiagnosis: "Diabetes"]
).verified ( ) ) PriorDiabetes
where "PriorDiabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-prediabetes-diagnosis-overlaps-2-year-look-back-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Prediabetes Diagnosis Overlaps 2 Year Look Back Period":
( ( ["ConditionProblemsHealthConcerns": "Prediabetes (Borderline Diabetes)"]
union [ConditionEncounterDiagnosis: "Prediabetes (Borderline Diabetes)"]
).verified ( ) ) PriorPrediabetes
where "PriorPrediabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-has-glycemic-laboratory-test-performed-during-2-year-look-back-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period":
exists ( [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Look Back Period"
and LabTestPerformed.status in { 'final', 'amended', 'corrected' }
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-denominator-exclusions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Has Pregnancy Observation During Measurement Period"
or exists "Has Pregnancy Diagnosis During Measurement Period"
or exists "Has Advanced Illness or Limited Life Expectancy"
or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1154screeningprediabetesfhir-verified"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):
conditions C
where C.verificationStatus is not null implies ( C.verificationStatus ~ "confirmed"
or C.verificationStatus ~ "unconfirmed"
or C.verificationStatus ~ "provisional"
or C.verificationStatus ~ "differential"
)</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system SNOMEDCT
<br/>
<em>Resource</em>: http://snomed.info/sct
<br/>
<em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system CDCREC
<br/>
<em>Resource</em>: urn:oid:2.16.840.1.113883.6.238
<br/>
<em>Canonical URL</em>: <tt>urn:oid:2.16.840.1.113883.6.238</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system ConditionVerificationStatusCodes
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Glycemic Screening Tests
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventative Clinical Encounters
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Outpatient Clinical Encounters
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Payer Type
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Pregnancy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Advanced Illness
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Limited Life Expectancy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Diabetes
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Prediabetes (Borderline Diabetes)
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Male (finding)
<br/>
<em>Code</em>: 248153007
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Female (finding)
<br/>
<em>Code</em>: 248152002
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Asian
<br/>
<em>Code</em>: 2028-9
<br/>
<em>System</em>: <tt>urn:oid:2.16.840.1.113883.6.238</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Confirmed
<br/>
<em>Code</em>: confirmed
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Unconfirmed
<br/>
<em>Code</em>: unconfirmed
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Provisional
<br/>
<em>Code</em>: provisional
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Differential
<br/>
<em>Code</em>: differential
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: QICore model information
<br/>
<em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library SDE
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library FHIRHelpers
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library QICoreCommon
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Patient
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
<br/>
<em>Must Support Elements</em>: extension, url, birthDate, birthDate.value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
<br/>
<em>Must Support Elements</em>: code, effective, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
<br/>
<em>Must Support Elements</em>: status, status.value, value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Coverage
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
<br/>
<em>Must Support Elements</em>: type, period
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus
<br/>
<em>Must Support Elements</em>: value, effective, effective.value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248153007"/>
<display value="Male (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248152002"/>
<display value="Female (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2028-9"/>
<display value="Asian"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="unconfirmed"/>
<display value="Unconfirmed"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="provisional"/>
<display value="Provisional"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="differential"/>
<display value="Differential"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Glycemic Laboratory Test Performed During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Glycemic Laboratory Test Performed During Measurement Period":
[LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Measurement Period"
and LabTestPerformed.status in { 'final', 'amended', 'corrected' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
exists "Glycemic Laboratory Test Performed During Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Preventive Care Outpatient Visits During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Preventive Care Outpatient Visits During Measurement Period":
[Encounter: "Preventative Clinical Encounters"] PreventiveCare
where PreventiveCare.period ends during day of "Measurement Period"
and PreventiveCare.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Office Visit During the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Office Visit During the Measurement Period":
[Encounter: "Outpatient Clinical Encounters"] OfficeVisit
where OfficeVisit.period during day of "Measurement Period"
and OfficeVisit.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Aged 35 to 70 at Start of Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Aged 35 to 70 at Start of Measurement Period":
"AgeInYearsAt"(date from start of "Measurement Period") between 35 and 70"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Patients Aged 35 to 70 with an Office Visit During the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Patients Aged 35 to 70 with an Office Visit During the Measurement Period":
( exists ( "Preventive Care Outpatient Visits During Measurement Period" )
or Count("Office Visit During the Measurement Period") >= 2
)
and "Aged 35 to 70 at Start of Measurement Period" is true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Most Recent BMI"/>
</extension>
<extension url="statement">
<valueString
value="define "Most Recent BMI":
First([USCoreBMIProfile] BMI
where BMI.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval() desc
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Patient is Asian"/>
</extension>
<extension url="statement">
<valueString
value="define "Patient is Asian":
exists ( SDE."SDE Race".codes C
where C ~ "Asian"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Patient is not Asian"/>
</extension>
<extension url="statement">
<valueString
value="define "Patient is not Asian":
not ( "Patient is Asian" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"/>
</extension>
<extension url="statement">
<valueString
value="define "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian":
"Most Recent BMI".value >= 25 'kg/m2'
and "Patient is not Asian""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Most Recent BMI Equal to or Greater Than 23 and Is Asian"/>
</extension>
<extension url="statement">
<valueString
value="define "Most Recent BMI Equal to or Greater Than 23 and Is Asian":
"Most Recent BMI".value >= 23 'kg/m2'
and "Patient is Asian""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
"Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Pregnancy Observation During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Pregnancy Observation During Measurement Period":
exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
where PregnantObservation.value in "Pregnancy"
and PregnantObservation.effective.toInterval ( ) overlaps day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Pregnancy Diagnosis During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Pregnancy Diagnosis During Measurement Period":
( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
union [ConditionEncounterDiagnosis: "Pregnancy"]
).verified ( ) ) PregnancyDx
where PregnancyDx.prevalenceInterval ( ) overlaps day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Advanced Illness or Limited Life Expectancy"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Advanced Illness or Limited Life Expectancy":
( ( ["ConditionProblemsHealthConcerns": "Advanced Illness"]
union ["ConditionEncounterDiagnosis": "Advanced Illness"]
union ["ConditionProblemsHealthConcerns": "Limited Life Expectancy"]
union ["ConditionEncounterDiagnosis": "Limited Life Expectancy"]
).verified ( ) ) AdvancedIllness
where "AdvancedIllness".onset before day of end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Look Back Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Look Back Period":
Interval[start of "Measurement Period" - 2 years, start of "Measurement Period" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Diabetes Diagnosis Overlaps 2 Year Look Back Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Diabetes Diagnosis Overlaps 2 Year Look Back Period":
( ( ["ConditionProblemsHealthConcerns": "Diabetes"]
union [ConditionEncounterDiagnosis: "Diabetes"]
).verified ( ) ) PriorDiabetes
where "PriorDiabetes".prevalenceInterval ( ) overlaps day of "Look Back Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Prediabetes Diagnosis Overlaps 2 Year Look Back Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Prediabetes Diagnosis Overlaps 2 Year Look Back Period":
( ( ["ConditionProblemsHealthConcerns": "Prediabetes (Borderline Diabetes)"]
union [ConditionEncounterDiagnosis: "Prediabetes (Borderline Diabetes)"]
).verified ( ) ) PriorPrediabetes
where "PriorPrediabetes".prevalenceInterval ( ) overlaps day of "Look Back Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period":
exists ( [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Look Back Period"
and LabTestPerformed.status in { 'final', 'amended', 'corrected' }
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
"Has Pregnancy Observation During Measurement Period"
or exists "Has Pregnancy Diagnosis During Measurement Period"
or exists "Has Advanced Illness or Limited Life Expectancy"
or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1154ScreeningPrediabetesFHIR"/>
</extension>
<extension url="name">
<valueString value="verified"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):
conditions C
where C.verificationStatus is not null implies ( C.verificationStatus ~ "confirmed"
or C.verificationStatus ~ "unconfirmed"
or C.verificationStatus ~ "provisional"
or C.verificationStatus ~ "differential"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="QICore model information"/>
<resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource
value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system SNOMEDCT"/>
<resource value="http://snomed.info/sct"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system CDCREC"/>
<resource value="urn:oid:2.16.840.1.113883.6.238"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionVerificationStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Glycemic Screening Tests"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Preventative Clinical Encounters"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Outpatient Clinical Encounters"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Pregnancy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Advanced Illness"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Limited Life Expectancy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Diabetes"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Prediabetes (Borderline Diabetes)"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="extension"/>
<mustSupport value="url"/>
<mustSupport value="birthDate"/>
<mustSupport value="birthDate.value"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="effective.value"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex.</p>"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/CMS1154ScreeningPrediabetesFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1154FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:d5fabe20-5aaa-4dea-bfb4-2fde59ea40d6"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:c116e4ae-6daf-49b2-b415-dd229215c674"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="publisher"/>
<display value="Publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1154FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="1.0.000"/>
<name value="CMS1154ScreeningPrediabetesFHIR"/>
<title
value="Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR
"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-08-21T14:25:52+00:00"/>
<publisher value="American Medical Association (AMA)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.ama-assn.org/"/>
</telecom>
</contact>
<description
value="Percentage of adult patients with risk factors for type 2 diabetes who are due for glycemic screening for whom the screening process was completed during the measurement period.
"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="venue"/>
<display value="Venue"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes"/>
<code value="ec"/>
<display value="EC"/>
</coding>
</valueCodeableConcept>
</useContext>
<usage
value="The measure is limited to patients aged 35 to 70 with overweight or obesity because it is recommended that all patients with those risk factors be screened for diabetes at least once every three years. However, this measure is not intended to discourage screening at younger ages, which the USPSTF recommends considering for adults with overweight or obesity and any of the following risk factors:
* Race/ethnicity with disproportionately high incidence and prevalence of diabetes (American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons)
* Family history of diabetes
* History of gestational diabetes
* History of polycystic ovarian syndrome
It is recommended that every patient evaluated by this measure also identify payer, race, ethnicity, and sex.
This eCQM is a patient-based measure.
This FHIR-based measure has been derived from the QDM-based measure CMS1154v1. 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 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
"/>
<copyright
value="Prediabetes Quality Measures (C) 2018-2025. American Medical Association. All rights reserved.
CPT (R) 2025 American Medical Association ("AMA"). All rights reserved. You cannot, without express written permission from the AMA, copy, modify, distribute, display, or use CPT for any commercial purpose, including for productive use in a clinical setting. Any such use requires a separate license from the AMA.
You agree that you shall not remove, obscure, or alter any proprietary rights notices (including copyright and trademark notices) which may be affixed to or contained within the measure.
Current Procedural Terminology (CPT \[R\] code(s) ("CPT Codes") information provided in the Measures is intended for reference and informational purposes only. Decisions regarding which CPT Code is appropriate must be made by physicians and/or their staff considering the clinical facts, circumstances, applicable coding and published AMA coding guideline and payor policies. The AMA does not dictate payer reimbursement policy and does not substitute for the professional judgment of the practitioner performing a procedure, who remains responsible for correct coding. The AMA is not engaged in the practice of medicine or dispensing medical services. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of the CPT code set, and the AMA is not recommending their use.
Information contained in the measure includes information protected by intellectual property rights which are owned by the AMA. The Measures may also contain proprietary code sets not owned by the AMA. The AMA disclaims all liability for the use or accuracy of any such information. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC \[R\] copyright 2004-2025 Regenstrief Institute, Inc., SNOMED CLINICAL TERMS (SNOMED CT\[R\]) copyright 2004-2025, The International Health Information Standards Development Organisation (IHTSDO). ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.
"/>
<effectivePeriod>
<start value="2026-01-01"/>
<end value="2026-12-31"/>
</effectivePeriod>
<author>
<name value="American Medical Association (AMA)"/>
<telecom>
<system value="url"/>
<value value="https://www.ama-assn.org/"/>
</telecom>
</author>
<author>
<name value="Health Services Advisory Group"/>
<telecom>
<system value="url"/>
<value value="https://www.hsag.com/en/"/>
</telecom>
</author>
<relatedArtifact>
<type value="citation"/>
<citation
value="Centers for Disease Control and Prevention. (2024, July 23). National Diabetes Statistics Report. Retrieved November 15, 2024, from Diabetes website: https://www.cdc.gov/diabetes/php/data-research/
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="U.S. Preventive Services Task Force. (2021). Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. JAMA, 326(8), 736--743. https://doi.org/10.1001/jama.2021.12531
"/>
</relatedArtifact>
<library
value="https://madie.cms.gov/Library/CMS1154ScreeningPrediabetesFHIR"/>
<disclaimer
value="The Prediabetes Quality Measure set descriptions and specifications (collectively, "Measures") are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures are not intended to diagnose or treat disease or other conditions. The Measures are not a medical device and have not been evaluated by the Food and Drug Administration. Information provided through the Measures is not intended to direct or substitute for the independent assessment or judgment of a qualified healthcare professional. The American Medical Association ("AMA") assumes no liability for use of the Measures, or data contained or not contained in the Measures.
The AMA consents to the use, reproduction and distribution of the Measures for non-commercial purposes only (e.g., for use by health care providers in a professional setting). You cannot, without the express written consent of the AMA, use the Measures for any commercial purpose. Unauthorized commercial use of the Measures is expressly prohibited. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed, or distributed for commercial gain. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.
To request to make a commercial use of the Measures, please email: AMA.IHO.QualityMeasures@ama-assn.org. Any commercial use of the Measures requires a separate license from the AMA.
Any use, publication or other dissemination of these Measures shall include the following attribution:
"This \[publication, etc.\] was prepared using clinical quality measures developed by the American Medical Association. The content reflects the views of \[name of author(s)\]."
USE OF THE MEASURES (INCLUDING ANY CPT CODES) IS AT YOUR SOLE RISK. THE MEASURES ARE PROVIDED "AS IS" WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT. AMA EXPRESSLY DISCLAIMS ANY AND ALL RESPONSIBILITY OR LIABILITY FOR DAMAGES OF ANY KIND ARISING OUT OF USE, REFERENCE TO, OR RELIANCE ON THE MEAUSURES.
These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.
Due to technical limitations, registered trademarks are indicated by (R) or \[R\] and unregistered trademarks are indicated by (TM) or \[TM\].
"/>
<rationale
value="This measure is critical to identifying patients with prediabetes who may benefit from interventions to prevent type 2 diabetes and identification of undiagnosed type 2 diabetes. The Centers for Disease Control and Prevention (CDC) estimates that approximately 97.6 million American adults have prediabetes (CDC, 2024). They note that more than 80% of adults with prediabetes are not aware that they have the condition. Regular screening for prediabetes is a critical first step to helping patients avoid the disability and costs associated with progression to type 2 diabetes.
The measure gives credit for three types of tests that can be used to detect abnormal glucose metabolism: HbA1c, oral glucose tolerance, and fasting plasma glucose. When considering which plasma glucose screening codes to include in the measure, the measure development team carefully considered two potential unintended consequences related to the limited use of accompanying fasting status codes. If the measure specified plasma glucose screening too narrowly, it could incentivize over screening, which would impose added burden on clinicians and increased costs to some patients. Alternatively, if the measure specified plasma glucose screening too broadly, it could give credit for non-fasting plasma glucose tests that are not adequate for diagnostic purposes.
"/>
<clinicalRecommendationStatement
value="The U.S. Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions (B recommendation) (USPSTF, 2021).
Evidence on the optimal screening interval for adults with an initial normal glucose test result is limited. Cohort and modeling studies suggest that screening every 3 years may be a reasonable approach for adults with normal blood glucose levels (USPSTF, 2021).
Prediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test. A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour post-load glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes (USPSTF, 2021).
"/>
<group id="Group_1">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="InitialPopulation_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="All patients with at least two outpatient clinical encounters or one preventive clinical encounter during the measurement period who have the following risk factors for type 2 diabetes:
* Most recent BMI ≥25 kg/m2 (BMI ≥23 kg/m2 for Asian patients) during measurement period, AND
* Age 35-70 at start of measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="Denominator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="All patients in the initial population.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="DenominatorExclusion_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Patient's pregnancy overlaps measurement period.
* Patient with diagnosis of advanced illness or limited life expectancy overlaps measurement period.
* Patient with diagnosis of diabetes overlaps 2-year look-back period.
* Patient with diagnosis of prediabetes overlaps 2-year look-back period.
* Patient with glycemic screening performed during 2-year look-back period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who had a glycemic screening test performed during the measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="individual"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="subject-list"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="summary"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="data-collection"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="individual"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="subject-list"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="summary"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="data-collection"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="individual"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="subject-list"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="summary"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="data-collection"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="individual"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="subject-list"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="summary"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
<valueCode value="data-collection"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>