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 2025-08-20 |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" class=\"col-12\">\n <table class=\"narrative-table\">\n <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n<td class=\"content-container\">Closing the Referral Loop: Receipt of Specialist ReportFHIR</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n<td class=\"content-container\">1.0.000</td>\n</tr>\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n<td class=\"content-container\">CMS50FHIR</td>\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n<td class=\"content-container\">urn:uuid:75691bbe-451e-4e3a-9a95-6361f7b45196</td>\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n<td class=\"content-container\">urn:uuid:00ad5281-ab7f-4e65-842f-b296dd094771</td>\n</tr>\n\n\n\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n<td class=\"content-container\">50FHIR</td>\n</tr>\n\n \n\n\n\n\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n</tr>\n\n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n<td class=\"content-container\">Centers for Medicare & Medicaid Services (CMS)</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n<td class=\"content-container\">American Institutes for Research (AIR)</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n<td class=\"content-container\"><p>Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred</p></td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n<td class=\"content-container\"><p>This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation.</p></td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n<td class=\"content-container\"><p>This performance Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p></td>\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n<td class=\"content-container\"><p>Problems in the outpatient referral and consultation process have been documented, including inadequate care pathways between specialty and primary care. Studies suggest that both specialists and primary care providers (PCPs) are not satisfied with current processes (Institute for Healthcare Improvement / National Patient Safety Foundation, 2017; Greenwood-Lee et. al, 2018). Breakdowns in referral communication leads to worse health outcomes, increased cost, and appointment delays (Patel et. al, 2018; Odisho et. al, 2020). A 2018 analysis of primary care referrals to specialists found that of the 103,737 referral scheduling attempts analyzed, only 36,072 (34.8%) resulted in documented complete appointments, defined by the specialty clinician providing report to the PCP after the referral visit (Patel et. al, 2018). Technological and process-based updates can improve the referral loop process and increase rates of closing the referral loop. Ramelson et. al (2018) enhanced an EHR's Referral Manager module to meet the Controlled Risk Insurance Company’s best practice steps and the requirements of both the CMS EHR Incentive Program and the National Committee for Quality Assurance Patient-Centered Medical Home program. Following the updates, 76.8% of referrals were completed and all defined referral process steps were easier to accomplish. Odisho et. al (2020) developed a referrals automation software to simplify the fax to referral process. Feedback from key stakeholder interviews noted that the software enhanced the referrals process by further streamlining and organizing the patient referral process. The Institute for Healthcare Improvement and the National Patient Safety Foundation (2017) reviewed the referrals process in the ambulatory care setting and found that organizational leaders, EHR vendors, regulatory agencies, clinicians, and patients all play a role in creating a referrals system that is effective, safe, convenient, and patient-centered.</p></td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n<td class=\"content-container\"><p>None</p></td>\n</tr>\n\n\n\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n <td class=\"content-container\">\n \n \n \n Greenwood-Lee, J., Jewett, L., Woodhouse, L., & Marshall, D. A. (2018). A categorisation of problems and solutions to improve patient referrals from primary to specialty care. BMC health services research, 18(1), 986. https://doi.org/10.1186/s12913-018-3745-y\n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n <td class=\"content-container\">\n \n \n \n Institute for Healthcare Improvement / National Patient Safety Foundation. (2017). Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era. https://www.ihi.org/resources/Pages/Publications/Closing-the-Loop-A-Guide-to-Safer-Ambulatory-Referrals.aspx\n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n <td class=\"content-container\">\n \n \n \n Odisho, A. Y., Lui, H., Yerramsetty, R., Bautista, F., Gleason, N., Martin, E., Young, J. J., Blum, M., & Neinstein, A. B. (2020). Design and development of referrals automation, a SMART on FHIR solution to improve patient access to specialty care. JAMIA open, 3(3), 405–412. https://doi.org/10.1093/jamiaopen/ooaa036\n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n <td class=\"content-container\">\n \n \n \n Patel, M. P., Schettini, P., O'Leary, C. P., Bosworth, H. B., Anderson, J. B., & Shah, K. P. (2018). Closing the Referral Loop: an Analysis of Primary Care Referrals to Specialists in a Large Health System. Journal of general internal medicine, 33(5), 715–721. https://doi.org/10.1007/s11606-018-4392-z\n \n \n \n \n \n </td>\n</tr>\n\n<tr>\n \n \n \n \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n \n \n <td class=\"content-container\">\n \n \n \n Ramelson, H., Nederlof, A., Karmiy, S., Neri, P., Kiernan, D., Krishnamurthy, R., Allen, A., & Bates, D. W. (2018). Closing the loop with an enhanced referral management system. Journal of the American Medical Informatics Association: JAMIA, 25(6), 715–721. https://doi.org/10.1093/jamia/ocy004\n \n \n \n \n \n </td>\n</tr>\n\n\n\n\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n<td class=\"content-container\">Referral: A request from one clinician to another clinician for evaluation, treatment, or co-management of a patient's condition. This term encompasses referral and consultation as defined by Centers for Medicare & Medicaid Services.</td>\n</tr>\n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n<td class=\"content-container\">Report: A written document prepared by the eligible clinician (and staff) to whom the patient was referred and that accounts for his or her findings, provides summary of care information about findings, diagnostics, assessments and/or plans of care, and is provided to the referring eligible clinician.</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n<td class=\"content-container\"><p>The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure. Only the first referral made between January 1 – October 31 of the measurement period will be considered for this measure to allow adequate time for the referring clinician to collect the consult report by the end of the measurement period. If there are multiple referrals for a patient during the measurement period, use the first referral. The clinician to whom the patient was referred is responsible for sending the consultant report that will fulfill the communication. Note: this is not the same clinician who would report on the measure. The consultant report that will successfully close the referral loop should be related to the first referral for a patient during the measurement period. If there are multiple consultant reports received by the referring clinician which pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible clinicians reporting on this measure should note that all data for the measurement period is to be submitted by the deadline established by CMS. Therefore, eligible clinicians who refer patients towards the end of the measurement period (i.e., October), should request that clinicians to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the measurement period. When clinicians to whom patients are referred communicate the consult report as soon as possible with the referring clinician, it ensures that the communication loop is closed in a timely manner and that the data are included in the submission to CMS. A procedural report received from a specialist for an exam or procedure conducted (e.g., diabetic eye exam, colonoscopy, etc.) can satisfy the numerator requirement and successfully close the referral loop. A separate consultant note or consultant report is not required to close the referral loop in these circumstances. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS50v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6.0.0 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>\n</tr>\n\n\n\n \n \n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Summary</th>\n\n\n<td class=\"content-container\"><p>Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred</p></td>\n</tr>\n\n \n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n<td class=\"content-container\">boolean</td>\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>\n</tr>\n\n\n\n\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>\n</tr>\n\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rate Aggregation</th>\n\n\n<td class=\"content-container\">None</td>\n</tr>\n\n\n\n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>\n</tr>\n\n\n \n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: InitialPopulation_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Number of patients, regardless of age, who had an encounter during the measurement period and were referred by one clinician to another clinician on or before October 31</p></p>\n \n \n \n \n <em>Logic Definition</em>: <a href=\"#primary-cms50fhirreceiptofspecialistreport-initial-population\">Initial Population</a> \n \n \n </td>\n </tr>\n \n\n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: Denominator_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Equals Initial Population</p></p>\n \n \n \n \n <em>Logic Definition</em>: <a href=\"#primary-cms50fhirreceiptofspecialistreport-denominator\">Denominator</a> \n \n \n </td>\n </tr>\n \n\n \n <tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n \n <td class=\"content-container\">\n \n <em>ID</em>: Numerator_1\n <br/>\n \n \n <em>Description</em>:\n <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Number of patients with a referral on or before October 31, for which the referring clinician received a report from the first clinician to whom the patient was referred</p></p>\n \n \n \n \n <em>Logic Definition</em>: <a href=\"#primary-cms50fhirreceiptofspecialistreport-numerator\">Numerator</a> \n \n \n </td>\n </tr>\n \n\n \n\n\n \n \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Guidance</th>\n\n\n<td class=\"content-container\">For every patient evaluated by this measure also identify payer, race, ethnicity and sex</td>\n</tr>\n\n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-ethnicity\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n \n <br/>\n \n \n \n <em>Description</em>: SDE Ethnicity\n \n \n \n <br/>\n \n <em>Logic Definition</em>: <a href=\"#cms50fhirreceiptofspecialistreport-sde-ethnicity\">SDE Ethnicity</a> \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-payer\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n \n <br/>\n \n \n \n <em>Description</em>: SDE Payer\n \n \n \n <br/>\n \n <em>Logic Definition</em>: <a href=\"#cms50fhirreceiptofspecialistreport-sde-payer\">SDE Payer</a> \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-race\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n \n <br/>\n \n \n \n <em>Description</em>: SDE Race\n \n \n \n <br/>\n \n <em>Logic Definition</em>: <a href=\"#cms50fhirreceiptofspecialistreport-sde-race\">SDE Race</a> \n \n \n </td>\n</tr>\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n <td class=\"content-container\">\n \n <em>ID</em>: sde-sex\n \n <br/>\n \n \n \n \n \n <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n \n <br/>\n \n \n \n <em>Description</em>: SDE Sex\n \n \n \n <br/>\n \n <em>Logic Definition</em>: <a href=\"#cms50fhirreceiptofspecialistreport-sde-sex\">SDE Sex</a> \n \n \n </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n<td class=\"content-container\">https://madie.cms.gov/Library/CMS50FHIRReceiptofSpecialistReport</td>\n</tr>\n\n\n\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Contents</th>\n <td class=\"content-container\">\n <em><a href=\"#population-criteria\">Population Criteria</a></em>\n <br/>\n <em><a href=\"#definitions\">Logic Definitions</a></em>\n <br/>\n <em><a href=\"#terminology\">Terminology</a></em>\n <br/>\n <em><a href=\"#dependencies\">Dependencies</a></em>\n <br/>\n <em><a href=\"#data-requirements\">Data Requirements</a></em>\n <br/>\n </td>\n</tr>\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n \n \n \n \n \n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"primary-cms50fhirreceiptofspecialistreport-initial-population\"> </a>\n \n \n Initial Population\n \n </th>\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n ( "Has Encounter during Measurement Period"\n or "Has Intervention during Measurement Period"\n )\n and "First Referral during First 10 Months of Measurement Period" is not null</code></pre>\n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"primary-cms50fhirreceiptofspecialistreport-denominator\"> </a>\n \n \n Denominator\n \n </th>\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"primary-cms50fhirreceiptofspecialistreport-numerator\"> </a>\n \n \n Numerator\n \n </th>\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "Referring Clinician Receives Consultant Report to Close Referral Loop"</code></pre>\n </td>\n\n</tr>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n \n \n \n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"supplementaldataelements-sde-sex\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.sex = '248153007' then "Male (finding)"\n when Patient.sex = '248152002' then "Female (finding)"\n else null\n end</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"supplementaldataelements-sde-payer\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"supplementaldataelements-sde-race\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-sde-sex\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-first-referral-during-first-10-months-of-measurement-period\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "First Referral during First 10 Months of Measurement Period":\n First([ServiceRequest: "Referral"] ReferralOrder\n where ReferralOrder.status in { 'active', 'completed' }\n and ReferralOrder.intent = 'order'\n and ReferralOrder.authoredOn during day of Interval[start of "Measurement Period", Date(year from start of "Measurement Period", 10, 31)]\n sort by authoredOn ascending\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-referring-clinician-receives-consultant-report-to-close-referral-loop\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Referring Clinician Receives Consultant Report to Close Referral Loop":\n exists ( [Task: QICoreCommon."Fulfill"] ConsultantReportObtained\n with "First Referral during First 10 Months of Measurement Period" FirstReferral\n // TODO: discuss with vendors .focus vs .basedOn\n \n such that ( ConsultantReportObtained.focus.references ( FirstReferral )\n or ConsultantReportObtained.basedOn.references ( FirstReferral )\n )\n and ConsultantReportObtained.executionPeriod ends after FirstReferral.authoredOn\n and ConsultantReportObtained.executionPeriod ends during day of "Measurement Period"\n and ConsultantReportObtained.status = 'completed'\n and ConsultantReportObtained.reasonCode in "Consultant Report"\n /*\n TODO: discuss usage of Composition resource for "Consultant Report"\n NOTE: the following does not currently work due to "Composition" missing a profile in QICore\n and exists(\n ConsultantReportObtained.output.value OV \n with ([Composition] ReportComposition where ReportComposition.type in "Consultant Report") ConsultantReportComposition \n such that (OV as Reference).references(ConsultantReportComposition)\n )\n */\n \n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-numerator\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "Referring Clinician Receives Consultant Report to Close Referral Loop"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-has-encounter-during-measurement-period\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Has Encounter during Measurement Period":\n exists ( ( ["Encounter": "Office Visit"]\n union ["Encounter": "Ophthalmological Services"]\n union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]\n union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]\n union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]\n union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"] ) ValidEncounter\n where ValidEncounter.status = 'finished'\n and ValidEncounter.period during day of "Measurement Period"\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-has-intervention-during-measurement-period\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Has Intervention during Measurement Period":\n exists ( ( ( ["Procedure": "Behavioral/Neuropsych Assessment"]\n union ["Procedure": "Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)"]\n union ["Procedure": "Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes"]\n union ["Procedure": "Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes"]\n union ["Procedure": "Psychotherapy for crisis; first 60 minutes"]\n union ["Procedure": "Psych Visit Diagnostic Evaluation"]\n union ["Procedure": "Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour"]\n ).isProcedurePerformed ( ) ) ValidIntervention\n where ValidIntervention.performed.toInterval ( ) during day of "Measurement Period"\n )</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-initial-population\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n ( "Has Encounter during Measurement Period"\n or "Has Intervention during Measurement Period"\n )\n and "First Referral during First 10 Months of Measurement Period" is not null</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-denominator\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-sde-payer\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-sde-ethnicity\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"cms50fhirreceiptofspecialistreport-sde-race\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> CMS50FHIRReceiptofSpecialistReport</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"status-isprocedureperformed\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> Status</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">//Procedure, Performed\ndefine fluent function isProcedurePerformed(Proc List<Procedure>):\n Proc P\n where P.status ~ 'completed'</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"qicorecommon-references\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n resource.id = Last(Split(reference.reference, '/'))</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"qicorecommon-references\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if any of the given references are to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(references List<Reference>, resource Resource):\n exists (references R where R.references(resource))</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"qicorecommon-tointerval\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n case\n\t when choice is DateTime then\n \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n\n \n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"fhirhelpers-tostring\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"fhirhelpers-tointerval\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n if period is null then\n null\n else\n if period."start" is null then\n Interval(period."start".value, period."end".value]\n else\n Interval[period."start".value, period."end".value]</code></pre>\n </td>\n\n</tr>\n\n\n\n \n\n\n\n \n\n\n\n \n\n\n<tr>\n <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n \n \n <a name=\"fhirhelpers-tocode\"> </a>\n \n Logic Definition\n </th>\n\n <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n\n</tr>\n\n\n\n\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n \n \n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system SNOMEDCT\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://snomed.info/sct\n <br/>\n <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system TaskCodeSystem\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://hl7.org/fhir/CodeSystem/task-code\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n \n <td class=\"content-container\">\n \n <em>Description</em>: Code system CPT\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://www.ama-assn.org/go/cpt\n <br/>\n <em>Canonical URL</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Referral\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Consultant Report\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.121.12.1006\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.121.12.1006</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Office Visit\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Ophthalmological Services\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Preventive Care Services Established Office Visit, 18 and Up\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Preventive Care Services, Initial Office Visit, 0 to 17\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Preventive Care Services Initial Office Visit, 18 and Up\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Preventive Care, Established Office Visit, 0 to 17\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Behavioral/Neuropsych Assessment\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Psych Visit Diagnostic Evaluation\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n \n \n <td class=\"content-container\">\n \n <em>Description</em>: Value set Payer Type\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n <br/>\n <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n \n </td>\n</tr>\n \n\n\n \n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Male (finding)\n <br/>\n \n <em>Code</em>: 248153007\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Female (finding)\n <br/>\n \n <em>Code</em>: 248152002\n <br/>\n <em>System</em>: <tt>http://snomed.info/sct</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Fulfill\n <br/>\n \n <em>Code</em>: fulfill\n <br/>\n <em>System</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)\n <br/>\n \n <em>Code</em>: 96156\n <br/>\n <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes\n <br/>\n \n <em>Code</em>: 96136\n <br/>\n <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes\n <br/>\n \n <em>Code</em>: 96138\n <br/>\n <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Psychotherapy for crisis; first 60 minutes\n <br/>\n \n <em>Code</em>: 90839\n <br/>\n <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n <td class=\"content-container\">\n \n <em>Display</em>: Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour\n <br/>\n \n <em>Code</em>: 96112\n <br/>\n <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>\n </td>\n </tr>\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n \n \n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: QICore model information\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo\n <br/>\n <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library SDE\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library FHIRHelpers\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library QICoreCommon\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>\n \n </td>\n</tr>\n \n\n\n<tr>\n \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n <td class=\"content-container\">\n \n <em>Description</em>: Library Status\n \n <br/>\n \n \n \n \n \n \n <em>Resource</em>: https://madie.cms.gov/Library/Status|1.15.000\n <br/>\n <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Status|1.15.000</tt>\n \n </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n \n \n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n \n \n \n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Patient\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient\n <br/> \n \n \n \n <em>Must Support Elements</em>: extension, birthDate, birthDate.value, url\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: ServiceRequest\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, intent, intent.value, authoredOn, authoredOn.value\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Resource\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/StructureDefinition/Resource\n <br/> \n \n \n \n <em>Must Support Elements</em>: id, id.value\n <br/>\n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Task\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, focus, basedOn, executionPeriod, status, status.value, reasonCode\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://hl7.org/fhir/CodeSystem/task-code#fulfill: 'Fulfill'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Encounter\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, status, status.value, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://www.ama-assn.org/go/cpt#96156: 'Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://www.ama-assn.org/go/cpt#96136: 'Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://www.ama-assn.org/go/cpt#96138: 'Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://www.ama-assn.org/go/cpt#90839: 'Psychotherapy for crisis; first 60 minutes'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492\n <br/> \n \n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Procedure\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n <br/> \n \n \n \n <em>Must Support Elements</em>: code, status, status.value, performed\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: code</span>\n <br/>\n \n \n \n \n <span class=\"tab-one\"><em>Code(s)</em>: \n \n \n http://www.ama-assn.org/go/cpt#96112: 'Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour'\n \n \n </span>\n <br/>\n \n \n \n </td>\n</tr>\n\n<tr>\n <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n <td class=\"content-container\">\n <em>Type</em>: Coverage\n <br/>\n \n <em>Profile(s)</em>: \n \n http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage\n <br/> \n \n \n \n <em>Must Support Elements</em>: type, period\n <br/>\n \n \n <em>Code Filter(s)</em>: \n <br/>\n \n \n <span class=\"tab-one\"><em>Path</em>: type</span>\n <br/>\n \n \n \n <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n <br/> \n \n \n \n \n </td>\n</tr>\n\n \n \n\n<tr>\n <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>\n</tr>\n\n </tbody>\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "248153007",
"display" : "Male (finding)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "248152002",
"display" : "Female (finding)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/CodeSystem/task-code",
"code" : "fulfill",
"display" : "Fulfill"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96156",
"display" : "Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96136",
"display" : "Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96138",
"display" : "Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "90839",
"display" : "Psychotherapy for crisis; first 60 minutes"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
"valueCoding" : {
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96112",
"display" : "Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.sex = '248153007' then \"Male (finding)\"\n when Patient.sex = '248152002' then \"Female (finding)\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "First Referral during First 10 Months of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"First Referral during First 10 Months of Measurement Period\":\n First([ServiceRequest: \"Referral\"] ReferralOrder\n where ReferralOrder.status in { 'active', 'completed' }\n and ReferralOrder.intent = 'order'\n and ReferralOrder.authoredOn during day of Interval[start of \"Measurement Period\", Date(year from start of \"Measurement Period\", 10, 31)]\n sort by authoredOn ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Referring Clinician Receives Consultant Report to Close Referral Loop"
},
{
"url" : "statement",
"valueString" : "define \"Referring Clinician Receives Consultant Report to Close Referral Loop\":\n exists ( [Task: QICoreCommon.\"Fulfill\"] ConsultantReportObtained\n with \"First Referral during First 10 Months of Measurement Period\" FirstReferral\n // TODO: discuss with vendors .focus vs .basedOn\n \n such that ( ConsultantReportObtained.focus.references ( FirstReferral )\n or ConsultantReportObtained.basedOn.references ( FirstReferral )\n )\n and ConsultantReportObtained.executionPeriod ends after FirstReferral.authoredOn\n and ConsultantReportObtained.executionPeriod ends during day of \"Measurement Period\"\n and ConsultantReportObtained.status = 'completed'\n and ConsultantReportObtained.reasonCode in \"Consultant Report\"\n /*\n TODO: discuss usage of Composition resource for \"Consultant Report\"\n NOTE: the following does not currently work due to \"Composition\" missing a profile in QICore\n and exists(\n ConsultantReportObtained.output.value OV \n with ([Composition] ReportComposition where ReportComposition.type in \"Consultant Report\") ConsultantReportComposition \n such that (OV as Reference).references(ConsultantReportComposition)\n )\n */\n \n )"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Referring Clinician Receives Consultant Report to Close Referral Loop\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Has Encounter during Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Has Encounter during Measurement Period\":\n exists ( ( [\"Encounter\": \"Office Visit\"]\n union [\"Encounter\": \"Ophthalmological Services\"]\n union [\"Encounter\": \"Preventive Care Services Established Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services, Initial Office Visit, 0 to 17\"]\n union [\"Encounter\": \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care, Established Office Visit, 0 to 17\"] ) ValidEncounter\n where ValidEncounter.status = 'finished'\n and ValidEncounter.period during day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Has Intervention during Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Has Intervention during Measurement Period\":\n exists ( ( ( [\"Procedure\": \"Behavioral/Neuropsych Assessment\"]\n union [\"Procedure\": \"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)\"]\n union [\"Procedure\": \"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes\"]\n union [\"Procedure\": \"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes\"]\n union [\"Procedure\": \"Psychotherapy for crisis; first 60 minutes\"]\n union [\"Procedure\": \"Psych Visit Diagnostic Evaluation\"]\n union [\"Procedure\": \"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour\"]\n ).isProcedurePerformed ( ) ) ValidIntervention\n where ValidIntervention.performed.toInterval ( ) during day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n ( \"Has Encounter during Measurement Period\"\n or \"Has Intervention during Measurement Period\"\n )\n and \"First Referral during First 10 Months of Measurement Period\" is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS50FHIRReceiptofSpecialistReport"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "references"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n resource.id = Last(Split(reference.reference, '/'))"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "references"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns true if any of the given references are to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(references List<Reference>, resource Resource):\n exists (references R where R.references(resource))"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n if period is null then\n null\n else\n if period.\"start\" is null then\n Interval(period.\"start\".value, period.\"end\".value]\n else\n Interval[period.\"start\".value, period.\"end\".value]"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Status"
},
{
"url" : "name",
"valueString" : "isProcedurePerformed"
},
{
"url" : "statement",
"valueString" : "//Procedure, Performed\ndefine fluent function isProcedurePerformed(Proc List<Procedure>):\n Proc P\n where P.status ~ 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "toInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n case\n\t when choice is DateTime then\n \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCode"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "QICore model information",
"resource" : "http://hl7.org/fhir/Library/QICore-ModelInfo"
},
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "https://madie.cms.gov/Library/FHIRHelpers|4.4.000"
},
{
"type" : "depends-on",
"display" : "Library QICoreCommon",
"resource" : "https://madie.cms.gov/Library/QICoreCommon|4.0.000"
},
{
"type" : "depends-on",
"display" : "Library Status",
"resource" : "https://madie.cms.gov/Library/Status|1.15.000"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system TaskCodeSystem",
"resource" : "http://hl7.org/fhir/CodeSystem/task-code"
},
{
"type" : "depends-on",
"display" : "Code system CPT",
"resource" : "http://www.ama-assn.org/go/cpt"
},
{
"type" : "depends-on",
"display" : "Value set Referral",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046"
},
{
"type" : "depends-on",
"display" : "Value set Consultant Report",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.121.12.1006"
},
{
"type" : "depends-on",
"display" : "Value set Office Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"type" : "depends-on",
"display" : "Value set Ophthalmological Services",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services Established Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services, Initial Office Visit, 0 to 17",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services Initial Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care, Established Office Visit, 0 to 17",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"
},
{
"type" : "depends-on",
"display" : "Value set Behavioral/Neuropsych Assessment",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023"
},
{
"type" : "depends-on",
"display" : "Value set Psych Visit Diagnostic Evaluation",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492"
},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
}
],
"dataRequirement" : [
{
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"mustSupport" : [
"extension",
"birthDate",
"birthDate.value",
"url"
]
},
{
"type" : "ServiceRequest",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"
],
"mustSupport" : [
"code",
"status",
"status.value",
"intent",
"intent.value",
"authoredOn",
"authoredOn.value"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046"
}
]
},
{
"type" : "Resource",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Resource"
],
"mustSupport" : [
"id",
"id.value"
]
},
{
"type" : "Task",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
],
"mustSupport" : [
"code",
"focus",
"basedOn",
"executionPeriod",
"status",
"status.value",
"reasonCode"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://hl7.org/fhir/CodeSystem/task-code",
"code" : "fulfill",
"display" : "Fulfill"
}
]
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"status",
"status.value",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96156",
"display" : "Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)"
}
]
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96136",
"display" : "Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes"
}
]
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96138",
"display" : "Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes"
}
]
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "90839",
"display" : "Psychotherapy for crisis; first 60 minutes"
}
]
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport" : [
"code",
"status",
"status.value",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "96112",
"display" : "Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour"
}
]
}
]
},
{
"type" : "Coverage",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"
],
"mustSupport" : [
"type",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
}
]
}
],
"extension" : [
{
"id" : "supplementalDataGuidance",
"extension" : [
{
"url" : "guidance",
"valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity and sex"
},
{
"url" : "usage",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data",
"display" : "Supplemental Data"
}
],
"text" : "Supplemental Data Guidance"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Referral"
},
{
"url" : "definition",
"valueMarkdown" : "A request from one clinician to another clinician for evaluation, treatment, or co-management of a patient's condition. This term encompasses referral and consultation as defined by Centers for Medicare \\& Medicaid Services.\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"extension" : [
{
"url" : "term",
"valueString" : "Report"
},
{
"url" : "definition",
"valueMarkdown" : "A written document prepared by the eligible clinician (and staff) to whom the patient was referred and that accounts for his or her findings, provides summary of care information about findings, diagnostics, assessments and/or plans of care, and is provided to the referring eligible clinician.\n"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
}
],
"url" : "https://madie.cms.gov/Measure/CMS50FHIRReceiptofSpecialistReport",
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "short-name",
"display" : "Short Name"
}
]
},
"system" : "https://madie.cms.gov/measure/shortName",
"value" : "CMS50FHIR"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "version-independent",
"display" : "Version Independent"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:75691bbe-451e-4e3a-9a95-6361f7b45196"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "version-specific",
"display" : "Version Specific"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:00ad5281-ab7f-4e65-842f-b296dd094771"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
"code" : "publisher",
"display" : "Publisher"
}
]
},
"system" : "https://madie.cms.gov/measure/cmsId",
"value" : "50FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "1.0.000",
"name" : "CMS50FHIRReceiptofSpecialistReport",
"title" : "Closing the Referral Loop: Receipt of Specialist ReportFHIR\n",
"status" : "active",
"experimental" : false,
"date" : "2025-08-20T14:36:52+00:00",
"publisher" : "Centers for Medicare & Medicaid Services (CMS)",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "https://www.cms.gov/"
}
]
}
],
"description" : "Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred\n",
"usage" : "The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure. Only the first referral made between January 1 -- October 31 of the measurement period will be considered for this measure to allow adequate time for the referring clinician to collect the consult report by the end of the measurement period. If there are multiple referrals for a patient during the measurement period, use the first referral. The clinician to whom the patient was referred is responsible for sending the consultant report that will fulfill the communication. Note: this is not the same clinician who would report on the measure. The consultant report that will successfully close the referral loop should be related to the first referral for a patient during the measurement period. If there are multiple consultant reports received by the referring clinician which pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible clinicians reporting on this measure should note that all data for the measurement period is to be submitted by the deadline established by CMS. Therefore, eligible clinicians who refer patients towards the end of the measurement period (i.e., October), should request that clinicians to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the measurement period. When clinicians to whom patients are referred communicate the consult report as soon as possible with the referring clinician, it ensures that the communication loop is closed in a timely manner and that the data are included in the submission to CMS. A procedural report received from a specialist for an exam or procedure conducted (e.g., diabetic eye exam, colonoscopy, etc.) can satisfy the numerator requirement and successfully close the referral loop. A separate consultant note or consultant report is not required to close the referral loop in these circumstances. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS50v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6.0.0 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n",
"copyright" : "This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare \\& Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-2024 International Health Terminology Standards Development Organisation.\n",
"effectivePeriod" : {
"start" : "2026-01-01",
"end" : "2026-12-31"
},
"author" : [
{
"name" : "American Institutes for Research (AIR)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.air.org"
}
]
}
],
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"type" : "citation",
"citation" : "Greenwood-Lee, J., Jewett, L., Woodhouse, L., \\& Marshall, D. A. (2018). A categorisation of problems and solutions to improve patient referrals from primary to specialty care. BMC health services research, 18(1), 986. https://doi.org/10.1186/s12913-018-3745-y\n"
},
{
"type" : "citation",
"citation" : "Institute for Healthcare Improvement / National Patient Safety Foundation. (2017). Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era. https://www.ihi.org/resources/Pages/Publications/Closing-the-Loop-A-Guide-to-Safer-Ambulatory-Referrals.aspx\n"
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"citation" : "Odisho, A. Y., Lui, H., Yerramsetty, R., Bautista, F., Gleason, N., Martin, E., Young, J. J., Blum, M., \\& Neinstein, A. B. (2020). Design and development of referrals automation, a SMART on FHIR solution to improve patient access to specialty care. JAMIA open, 3(3), 405--412. https://doi.org/10.1093/jamiaopen/ooaa036\n"
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"citation" : "Patel, M. P., Schettini, P., O'Leary, C. P., Bosworth, H. B., Anderson, J. B., \\& Shah, K. P. (2018). Closing the Referral Loop: an Analysis of Primary Care Referrals to Specialists in a Large Health System. Journal of general internal medicine, 33(5), 715--721. https://doi.org/10.1007/s11606-018-4392-z\n"
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"citation" : "Ramelson, H., Nederlof, A., Karmiy, S., Neri, P., Kiernan, D., Krishnamurthy, R., Allen, A., \\& Bates, D. W. (2018). Closing the loop with an enhanced referral management system. Journal of the American Medical Informatics Association: JAMIA, 25(6), 715--721. https://doi.org/10.1093/jamia/ocy004\n"
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"rationale" : "Problems in the outpatient referral and consultation process have been documented, including inadequate care pathways between specialty and primary care. Studies suggest that both specialists and primary care providers (PCPs) are not satisfied with current processes (Institute for Healthcare Improvement / National Patient Safety Foundation, 2017; Greenwood-Lee et. al, 2018). Breakdowns in referral communication leads to worse health outcomes, increased cost, and appointment delays (Patel et. al, 2018; Odisho et. al, 2020). A 2018 analysis of primary care referrals to specialists found that of the 103,737 referral scheduling attempts analyzed, only 36,072 (34.8%) resulted in documented complete appointments, defined by the specialty clinician providing report to the PCP after the referral visit (Patel et. al, 2018). Technological and process-based updates can improve the referral loop process and increase rates of closing the referral loop. Ramelson et. al (2018) enhanced an EHR's Referral Manager module to meet the Controlled Risk Insurance Company's best practice steps and the requirements of both the CMS EHR Incentive Program and the National Committee for Quality Assurance Patient-Centered Medical Home program. Following the updates, 76.8% of referrals were completed and all defined referral process steps were easier to accomplish. Odisho et. al (2020) developed a referrals automation software to simplify the fax to referral process. Feedback from key stakeholder interviews noted that the software enhanced the referrals process by further streamlining and organizing the patient referral process. The Institute for Healthcare Improvement and the National Patient Safety Foundation (2017) reviewed the referrals process in the ambulatory care setting and found that organizational leaders, EHR vendors, regulatory agencies, clinicians, and patients all play a role in creating a referrals system that is effective, safe, convenient, and patient-centered.\n",
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