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 2025-08-22 |
<Measure xmlns="http://hl7.org/fhir">
<id value="CMS771FHIRUrinarySymptomScoreBPH"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" class="col-12">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header">Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaFHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">1.0.000</td>
</tr>
<tr>
<th scope="row" class="row-header">Short Name</th>
<td class="content-container">CMS771FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:0748d873-8e20-441e-9bbf-c1eefe3ea054</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:1765122b-5409-43cb-9449-3d1a62a8ea78</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">771FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2026-01-01 through 2026-12-31</td>
</tr>
<tr>
<th scope="row" class="row-header">Steward (Publisher)</th>
<td class="content-container">Large Urology Group Practice Association (LUGPA)</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">Large Urology Group Practice Association (LUGPA)</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container"><p>Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container"><p>Limited proprietary coding is contained in the measure specifications for user convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Large Urology Group Practice Association (LUGPA) and Oregon Urology Institute (OUI) disclaim all liability for the use or accuracy of any third-party codes contained in the specifications.</p>
<p>CPT(R) contained in the Measure specifications is copyright 2004-2024. American Medical Association. LOINC(R) 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. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Disclaimer</th>
<td class="content-container"><p>The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications.</p>
<p>THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R], and unregistered trademarks are indicated by (TM) or [TM].</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Rationale</th>
<td class="content-container"><p>Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting older males, with a prevalence of 50% by age 60 years and 90% by the ninth decade of life (Medina et al., 1999). The enlarged gland had been proposed to contribute to the overall lower urinary tract symptoms (LUTS) complex (McVary et al., 2014). Although LUTS secondary to BPH is not often a life-threatening condition, the impact of LUTS/BPH on quality of life can be significant (Wei et al., 2005). The American Urological Association Symptom Index (AUA-SI) and the International Prostate Symptom Score (IPSS) were developed to measure outcomes in studies of different treatments for BPH (Wuerstle et al., 2011). The IPSS uses the same questions as the AUA-SI, but also adds a disease-specific Quality of Life (QOL) score question (O'Leary, 2005). The IPSS was adopted in 1993 by the World Health Organization. It is a reproducible, validated index designed to determine disease severity and response to therapy (D’Silva et al., 2014). It includes 3 storage symptom questions (frequency, nocturia, urgency) and four voiding symptoms (feeling of incomplete emptying, intermittency, straining, and a weak stream) as well as a Bother question: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? A three-point improvement in the score is considered meaningful (McVary et al., 2014).</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container"><p>The symptoms of BPH are lower urinary tract symptoms (LUTS). There are other disorders with similar symptoms that need to be excluded. History, physical examination, and testing are required prior to a diagnosis of BPH. IPSS by itself is not a reliable diagnostic tool for LUTS suggestive of BPH but serves as a quantitative measure of LUTS after the diagnosis is established (D’Silva et al., 2014). Medical and surgical interventions for BPH recommend a follow up IPSS evaluation to determine effectiveness of treatment. IPSS should be evaluated at the time of diagnosis and after definitive treatment.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>D'Silva, K. A., Dahm, P., & Wong, C. L. (2014). Does this man with lower urinary tract symptoms have bladder outlet obstruction? The Rational Clinical Examination: A systematic review. Journal of the American Medical Association, 312(5), 535-542. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25096693</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>McVary, K. T., Roehrborn, C. G., Avins, A. L., et al. (2014). Management of benign prostatic hyperplasia. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21420124/</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>Medina, J. J., Parra, R. O., & Moore, R. G. (1999). Benign prostatic hyperplasia (the aging prostate). Medical Clinics of North America, 83(5), 1213-1229. Retrieved from http://www.sciencedirect.com/science/article/pii/S0025712505701590</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>O'Leary, M. P. (2005). Validity of the Bother Score in the evaluation and treatment of symptomatic benign prostatic hyperplasia. Reviews in Urology, 7(1), 1-10. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477553/</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>Wei, J., Calhoun, E., & Jacobsen, S. (2005). Urologic diseases in America project: Benign prostatic hyperplasia. Journal of Urology, 173(4), 1256-1261. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15758764</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<p>Wuerstle, M. C., Van Den Eeden, S. K., Poon, K. T., et al. (2011). Contribution of common medications to lower urinary tract symptoms in men. Archives of Internal Medicine, 171(18), 1680-1682. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21987200</p>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Clinically Significant Benign Prostatic Hyperplasia (BPH) : <p>BPH with lower urinary tract symptoms (LUTS)</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container"><p>The IPSS is inclusive of the symptom index score and the Quality of Life (QOL) score. The AUA-SI is the symptom index score alone and must be added to the QOL score. The AUA-SI with the QOL equals the IPSS. Both of these are the urinary symptom score.</p>
<p>The patient must have a urinary symptom score (USS) within 1 month after initial diagnosis. If more than one USS in the initial one month, then the first USS counts. The patient must have a USS again at 6-12 months after the initial diagnosis and if more than one USS in this time frame, then the last USS counts.</p>
<p>The result of the test is a numeric value that relates to a continuous numeric scale. Reported either as an integer, a ratio, a real number, or a range. The test result value may optionally contain a relational operator from the set {<=, <, >, >=}. Valid values for a quantitative test are of the form “7”, “-7”, “7.4”, “-7.4”, “7.8912”, “0.125”, “<10”, “<10.15”, “>12000”, 1-10, 1:256.</p>
<p>Hospitalization within 30 days of Initial BPH Diagnosis refers to a 30-day period between the end of the hospitalization and the clinical office setting BPH diagnosis. This is due to aggravating factors from hospitalization, such as bed rest, medications, surgery, and altered body functions.</p>
<p>Symptoms of BPH include urinary frequency, urinary urgency, difficulty starting urination, weak urine stream, dribbling at the end of urination, incomplete bladder emptying.</p>
<p>This eCQM is a patient-based measure.</p>
<p>Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth.</p>
<p>This FHIR-based measure has been derived from the QDM-based measure CMS771v7. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container"><p>None</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: InitialPopulation_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to the measurement period who had a qualifying visit during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms771fhirurinarysymptomscorebph-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients in the Initial Population with a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months</p></p>
<em>Logic Definition</em>: <a href="#primary-cms771fhirurinarysymptomscorebph-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients with urinary retention that starts within 1 year of initial BPH diagnosis. Patients with an initial BPH diagnosis that starts during, or within 30 days after end of hospitalization.</p>
<p>Patients with a diagnosis of morbid obesity, or with a BMI Exam >=40 before the follow up urinary symptom score.</p></p>
<em>Logic Definition</em>: <a href="#primary-cms771fhirurinarysymptomscorebph-denominator-exclusions">Denominator Exclusions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms771fhirurinarysymptomscorebph-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Guidance</th>
<td class="content-container"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-ethnicity
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Ethnicity
<br/>
<em>Logic Definition</em>: <a href="#cms771fhirurinarysymptomscorebph-sde-ethnicity">SDE Ethnicity</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-payer
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Payer
<br/>
<em>Logic Definition</em>: <a href="#cms771fhirurinarysymptomscorebph-sde-payer">SDE Payer</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-race
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Race
<br/>
<em>Logic Definition</em>: <a href="#cms771fhirurinarysymptomscorebph-sde-race">SDE Race</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-sex
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Sex
<br/>
<em>Logic Definition</em>: <a href="#cms771fhirurinarysymptomscorebph-sde-sex">SDE Sex</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container">https://madie.cms.gov/Library/CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms771fhirurinarysymptomscorebph-initial-population"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
( "Patient is Male" )
and "Has Qualifying Encounter"
and "Has Qualifying BPH Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms771fhirurinarysymptomscorebph-denominator"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"
and "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" is not null
and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" is not null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms771fhirurinarysymptomscorebph-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )
or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )
or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms771fhirurinarysymptomscorebph-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Urinary Symptom Score Improvement Greater Than or Equal To 3"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-documented-ipss-assessment-result"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Documented IPSS Assessment Result":
[ObservationScreeningAssessment: "International Prostate Symptom Score [IPSS]"] IPSSAssessment
where IPSSAssessment.status in { 'final', 'amended', 'corrected' }
and IPSSAssessment.value is not null
return {
effectiveDatetime: IPSSAssessment.effective.earliest ( ),
valueInteger: IPSSAssessment.value as Integer
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-aua-symptom-index-and-quality-of-life-assessment-result"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "AUA Symptom Index and Quality of Life Assessment Result":
[ObservationScreeningAssessment: "American Urological Association Symptom Index [AUASI]"] AUASIAssessment
let LastQOLOnDate: Last([ObservationScreeningAssessment: "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"] QOLAssessment
where QOLAssessment.effective.earliest() same day as AUASIAssessment.effective.earliest()
and QOLAssessment.status in { 'final', 'amended', 'corrected' }
and QOLAssessment.value is not null
sort by effective.earliest()
)
where AUASIAssessment.status in { 'final', 'amended', 'corrected' }
and AUASIAssessment.value is not null
return {
effectiveDatetime: AUASIAssessment.effective.earliest ( ),
valueInteger: ( AUASIAssessment.value as Integer ) + ( LastQOLOnDate.value as Integer )
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-symptom-score-assessment"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Symptom Score Assessment":
"Documented IPSS Assessment Result"
union "AUA Symptom Index and Quality of Life Assessment Result"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-initial-bph-diagnosis-starts-within-6-months-before-the-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period":
First(([ConditionProblemsHealthConcerns: "Benign prostatic hyperplasia with lower urinary tract symptoms"]
union [ConditionEncounterDiagnosis: "Benign prostatic hyperplasia with lower urinary tract symptoms"]) NewBPHDiagnosis
where NewBPHDiagnosis.prevalenceInterval() starts during Interval[start of "Measurement Period" - 6 months, start of "Measurement Period"]
and NewBPHDiagnosis.verificationStatusIsNotInvalid()
sort by start of onset.toInterval()
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-symptom-score-within-1-month-after-initial-bph-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis":
First("Urinary Symptom Score Assessment" USSAssessment
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that USSAssessment.effectiveDatetime 1 month or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval()
sort by effectiveDatetime
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-symptom-score-6-to-12-months-after-initial-bph-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis":
Last("Urinary Symptom Score Assessment" USSAssessment
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that difference in months between start of InitialBPHDiagnosis.prevalenceInterval() and USSAssessment.effectiveDatetime in Interval[6, 12]
sort by effectiveDatetime
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-symptom-score-change"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Symptom Score Change":
from
"Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" FirstUSSAssessment,
"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
let USSChange: ( FirstUSSAssessment.valueInteger ) - ( FollowUpUSSAssessment.valueInteger )
return USSChange</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-symptom-score-improvement-greater-than-or-equal-to-3"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Symptom Score Improvement Greater Than or Equal To 3":
( "Urinary Symptom Score Change" USSImprovement
where USSImprovement >= 3
) is not null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Urinary Symptom Score Improvement Greater Than or Equal To 3"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-patient-is-male"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patient is Male":
SDE."SDE Sex" ~ SDE."Male (finding)"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-has-qualifying-encounter"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Qualifying Encounter":
exists ( [Encounter: "Office Visit"] ValidEncounter
where ValidEncounter.period during day of "Measurement Period"
and ValidEncounter.class !~ "virtual"
and ValidEncounter.status = 'finished'
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-has-qualifying-bph-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Qualifying BPH Diagnosis":
"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" is not null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
( "Patient is Male" )
and "Has Qualifying Encounter"
and "Has Qualifying BPH Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"
and "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" is not null
and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" is not null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-urinary-retention-diagnosis-starts-within-1-year-after-initial-bph-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis":
( [ConditionProblemsHealthConcerns: "Urinary Retention"]
union [ConditionEncounterDiagnosis: "Urinary Retention"] ) UrinaryRetention
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that UrinaryRetention.prevalenceInterval ( ) starts 1 year or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval ( )
where UrinaryRetention.verificationStatusIsNotInvalid ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-has-initial-bph-diagnosis-starts-during-or-within-30-days-after-end-of-hospitalization"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization":
"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
with [Encounter: "Hospital Services for Urology Care"] UrologyHospitalServices
such that InitialBPHDiagnosis.prevalenceInterval ( ) starts during Interval[start of UrologyHospitalServices.period, end of UrologyHospitalServices.period + 31 days]
and UrologyHospitalServices.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-morbid-obesity-diagnosis-on-or-before-follow-up-uss-assessment"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment":
( [ConditionProblemsHealthConcerns: "Morbid Obesity"]
union [ConditionEncounterDiagnosis: "Morbid Obesity"] ) MorbidObesityDiagnosis
with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
such that MorbidObesityDiagnosis.prevalenceInterval ( ) overlaps "Measurement Period"
and MorbidObesityDiagnosis.prevalenceInterval ( ) starts on or before FollowUpUSSAssessment.effectiveDatetime
where MorbidObesityDiagnosis.verificationStatusIsNotInvalid ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-bmi-exam-result-greater-than-or-equal-to-40-during-measurement-period-and-on-or-before-follow-up-uss-assessment"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
* @code: Body mass index (BMI) [Ratio] - 39156-5
* @profile: http://hl7.org/fhir/StructureDefinition/bmi
*/
define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment":
exists ( ["USCoreBMIProfile"] BMIExam
with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
such that BMIExam.value >= 40 'kg/m2'
and BMIExam.status in { 'final', 'amended', 'corrected' }
and BMIExam.effective.earliest ( ) during day of "Measurement Period"
and BMIExam.effective.earliest ( ) on or before FollowUpUSSAssessment.effectiveDatetime
return BMIExam.effective.earliest ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-morbid-obesity-diagnosis-or-bmi-exam-result-greater-than-or-equal-to-40-starts-on-or-before-follow-up-uss-assessment"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment":
exists "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"
or "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-denominator-exclusions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )
or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )
or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms771fhirurinarysymptomscorebph-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS771FHIRUrinarySymptomScoreBPH</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-earliest"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-hasstart"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Given an interval, return true if the interval has a starting boundary specified
(i.e. the start of the interval is not null and not the minimum DateTime value)
*/
define fluent function hasStart(period Interval<DateTime> ):
not ( start of period is null
or start of period = minimum DateTime
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tostring"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tointerval"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tocode"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system SNOMEDCT
<br/>
<em>Resource</em>: http://snomed.info/sct
<br/>
<em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system LOINC
<br/>
<em>Resource</em>: http://loinc.org
<br/>
<em>Canonical URL</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system ICD10CM
<br/>
<em>Resource</em>: http://hl7.org/fhir/sid/icd-10-cm
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system ActCode
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/v3-ActCode
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Office Visit
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Payer Type
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Urinary Retention
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospital Services for Urology Care
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Morbid Obesity
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Male (finding)
<br/>
<em>Code</em>: 248153007
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Female (finding)
<br/>
<em>Code</em>: 248152002
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: International Prostate Symptom Score [IPSS]
<br/>
<em>Code</em>: 80976-4
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: American Urological Association Symptom Index [AUASI]
<br/>
<em>Code</em>: 80883-2
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]
<br/>
<em>Code</em>: 81090-3
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Benign prostatic hyperplasia with lower urinary tract symptoms
<br/>
<em>Code</em>: N40.1
<br/>
<em>System</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: virtual
<br/>
<em>Code</em>: VR
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: QICore model information
<br/>
<em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library SDE
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library FHIRHelpers
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library QICoreCommon
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Patient
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
<br/>
<em>Must Support Elements</em>: extension, url
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, effective, status, status.value, value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#80883-2: 'American Urological Association Symptom Index [AUASI]'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, effective, status, status.value, value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#81090-3: 'If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, status, status.value, value, effective
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#80976-4: 'International Prostate Symptom Score [IPSS]'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://hl7.org/fhir/sid/icd-10-cm#N40.1: 'Benign prostatic hyperplasia with lower urinary tract symptoms'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://hl7.org/fhir/sid/icd-10-cm#N40.1: 'Benign prostatic hyperplasia with lower urinary tract symptoms'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, class, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Coverage
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
<br/>
<em>Must Support Elements</em>: type, period
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
<br/>
<em>Must Support Elements</em>: value, status, status.value, effective
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248153007"/>
<display value="Male (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248152002"/>
<display value="Female (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="80976-4"/>
<display value="International Prostate Symptom Score [IPSS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="80883-2"/>
<display
value="American Urological Association Symptom Index [AUASI]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="81090-3"/>
<display
value="If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="N40.1"/>
<display
value="Benign prostatic hyperplasia with lower urinary tract symptoms"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="VR"/>
<display value="virtual"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Documented IPSS Assessment Result"/>
</extension>
<extension url="statement">
<valueString
value="define "Documented IPSS Assessment Result":
[ObservationScreeningAssessment: "International Prostate Symptom Score [IPSS]"] IPSSAssessment
where IPSSAssessment.status in { 'final', 'amended', 'corrected' }
and IPSSAssessment.value is not null
return {
effectiveDatetime: IPSSAssessment.effective.earliest ( ),
valueInteger: IPSSAssessment.value as Integer
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="AUA Symptom Index and Quality of Life Assessment Result"/>
</extension>
<extension url="statement">
<valueString
value="define "AUA Symptom Index and Quality of Life Assessment Result":
[ObservationScreeningAssessment: "American Urological Association Symptom Index [AUASI]"] AUASIAssessment
let LastQOLOnDate: Last([ObservationScreeningAssessment: "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"] QOLAssessment
where QOLAssessment.effective.earliest() same day as AUASIAssessment.effective.earliest()
and QOLAssessment.status in { 'final', 'amended', 'corrected' }
and QOLAssessment.value is not null
sort by effective.earliest()
)
where AUASIAssessment.status in { 'final', 'amended', 'corrected' }
and AUASIAssessment.value is not null
return {
effectiveDatetime: AUASIAssessment.effective.earliest ( ),
valueInteger: ( AUASIAssessment.value as Integer ) + ( LastQOLOnDate.value as Integer )
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Urinary Symptom Score Assessment"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Symptom Score Assessment":
"Documented IPSS Assessment Result"
union "AUA Symptom Index and Quality of Life Assessment Result""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period":
First(([ConditionProblemsHealthConcerns: "Benign prostatic hyperplasia with lower urinary tract symptoms"]
union [ConditionEncounterDiagnosis: "Benign prostatic hyperplasia with lower urinary tract symptoms"]) NewBPHDiagnosis
where NewBPHDiagnosis.prevalenceInterval() starts during Interval[start of "Measurement Period" - 6 months, start of "Measurement Period"]
and NewBPHDiagnosis.verificationStatusIsNotInvalid()
sort by start of onset.toInterval()
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis":
First("Urinary Symptom Score Assessment" USSAssessment
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that USSAssessment.effectiveDatetime 1 month or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval()
sort by effectiveDatetime
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis":
Last("Urinary Symptom Score Assessment" USSAssessment
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that difference in months between start of InitialBPHDiagnosis.prevalenceInterval() and USSAssessment.effectiveDatetime in Interval[6, 12]
sort by effectiveDatetime
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Urinary Symptom Score Change"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Symptom Score Change":
from
"Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" FirstUSSAssessment,
"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
let USSChange: ( FirstUSSAssessment.valueInteger ) - ( FollowUpUSSAssessment.valueInteger )
return USSChange"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Urinary Symptom Score Improvement Greater Than or Equal To 3"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Symptom Score Improvement Greater Than or Equal To 3":
( "Urinary Symptom Score Change" USSImprovement
where USSImprovement >= 3
) is not null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Urinary Symptom Score Improvement Greater Than or Equal To 3""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Patient is Male"/>
</extension>
<extension url="statement">
<valueString
value="define "Patient is Male":
SDE."SDE Sex" ~ SDE."Male (finding)""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Has Qualifying Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Qualifying Encounter":
exists ( [Encounter: "Office Visit"] ValidEncounter
where ValidEncounter.period during day of "Measurement Period"
and ValidEncounter.class !~ "virtual"
and ValidEncounter.status = 'finished'
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Has Qualifying BPH Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Qualifying BPH Diagnosis":
"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" is not null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
( "Patient is Male" )
and "Has Qualifying Encounter"
and "Has Qualifying BPH Diagnosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population"
and "Urinary Symptom Score Within 1 Month After Initial BPH Diagnosis" is not null
and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" is not null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis":
( [ConditionProblemsHealthConcerns: "Urinary Retention"]
union [ConditionEncounterDiagnosis: "Urinary Retention"] ) UrinaryRetention
with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
such that UrinaryRetention.prevalenceInterval ( ) starts 1 year or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval ( )
where UrinaryRetention.verificationStatusIsNotInvalid ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization":
"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis
with [Encounter: "Hospital Services for Urology Care"] UrologyHospitalServices
such that InitialBPHDiagnosis.prevalenceInterval ( ) starts during Interval[start of UrologyHospitalServices.period, end of UrologyHospitalServices.period + 31 days]
and UrologyHospitalServices.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"/>
</extension>
<extension url="statement">
<valueString
value="define "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment":
( [ConditionProblemsHealthConcerns: "Morbid Obesity"]
union [ConditionEncounterDiagnosis: "Morbid Obesity"] ) MorbidObesityDiagnosis
with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
such that MorbidObesityDiagnosis.prevalenceInterval ( ) overlaps "Measurement Period"
and MorbidObesityDiagnosis.prevalenceInterval ( ) starts on or before FollowUpUSSAssessment.effectiveDatetime
where MorbidObesityDiagnosis.verificationStatusIsNotInvalid ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"/>
</extension>
<extension url="statement">
<valueString
value="/*
* @code: Body mass index (BMI) [Ratio] - 39156-5
* @profile: http://hl7.org/fhir/StructureDefinition/bmi
*/
define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment":
exists ( ["USCoreBMIProfile"] BMIExam
with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment
such that BMIExam.value >= 40 'kg/m2'
and BMIExam.status in { 'final', 'amended', 'corrected' }
and BMIExam.effective.earliest ( ) during day of "Measurement Period"
and BMIExam.effective.earliest ( ) on or before FollowUpUSSAssessment.effectiveDatetime
return BMIExam.effective.earliest ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString
value="Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment"/>
</extension>
<extension url="statement">
<valueString
value="define "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment":
exists "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"
or "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )
or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )
or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS771FHIRUrinarySymptomScoreBPH"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="earliest"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="hasStart"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, return true if the interval has a starting boundary specified
(i.e. the start of the interval is not null and not the minimum DateTime value)
*/
define fluent function hasStart(period Interval<DateTime> ):
not ( start of period is null
or start of period = minimum DateTime
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="QICore model information"/>
<resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource
value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system SNOMEDCT"/>
<resource value="http://snomed.info/sct"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ICD10CM"/>
<resource value="http://hl7.org/fhir/sid/icd-10-cm"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ActCode"/>
<resource value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Office Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Urinary Retention"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospital Services for Urology Care"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Morbid Obesity"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="extension"/>
<mustSupport value="url"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="80883-2"/>
<display
value="American Urological Association Symptom Index [AUASI]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="81090-3"/>
<display
value="If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="80976-4"/>
<display value="International Prostate Symptom Score [IPSS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="N40.1"/>
<display
value="Benign prostatic hyperplasia with lower urinary tract symptoms"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="N40.1"/>
<display
value="Benign prostatic hyperplasia with lower urinary tract symptoms"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.372"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.368"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="class"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.360"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString
value="Clinically Significant Benign Prostatic Hyperplasia (BPH) "/>
</extension>
<extension url="definition">
<valueMarkdown value="BPH with lower urinary tract symptoms (LUTS)
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="https://madie.cms.gov/Measure/CMS771FHIRUrinarySymptomScoreBPH"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS771FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:0748d873-8e20-441e-9bbf-c1eefe3ea054"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:1765122b-5409-43cb-9449-3d1a62a8ea78"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="publisher"/>
<display value="Publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="771FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="1.0.000"/>
<name value="CMS771FHIRUrinarySymptomScoreBPH"/>
<title
value="Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaFHIR
"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-08-22T18:48:37+00:00"/>
<publisher value="Large Urology Group Practice Association (LUGPA)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.lugpa.org/"/>
</telecom>
</contact>
<description
value="Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points
"/>
<usage
value="The IPSS is inclusive of the symptom index score and the Quality of Life (QOL) score. The AUA-SI is the symptom index score alone and must be added to the QOL score. The AUA-SI with the QOL equals the IPSS. Both of these are the urinary symptom score.
The patient must have a urinary symptom score (USS) within 1 month after initial diagnosis. If more than one USS in the initial one month, then the first USS counts. The patient must have a USS again at 6-12 months after the initial diagnosis and if more than one USS in this time frame, then the last USS counts.
The result of the test is a numeric value that relates to a continuous numeric scale. Reported either as an integer, a ratio, a real number, or a range. The test result value may optionally contain a relational operator from the set {\<=, \<, \>, \>=}. Valid values for a quantitative test are of the form "7", "-7", "7.4", "-7.4", "7.8912", "0.125", "\<10", "\<10.15", "\>12000", 1-10, 1:256.
Hospitalization within 30 days of Initial BPH Diagnosis refers to a 30-day period between the end of the hospitalization and the clinical office setting BPH diagnosis. This is due to aggravating factors from hospitalization, such as bed rest, medications, surgery, and altered body functions.
Symptoms of BPH include urinary frequency, urinary urgency, difficulty starting urination, weak urine stream, dribbling at the end of urination, incomplete bladder emptying.
This eCQM is a patient-based measure.
Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth.
This FHIR-based measure has been derived from the QDM-based measure CMS771v7. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
"/>
<copyright
value="Limited proprietary coding is contained in the measure specifications for user convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Large Urology Group Practice Association (LUGPA) and Oregon Urology Institute (OUI) disclaim all liability for the 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) 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. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.
"/>
<effectivePeriod>
<start value="2026-01-01"/>
<end value="2026-12-31"/>
</effectivePeriod>
<author>
<name value="Large Urology Group Practice Association (LUGPA)"/>
<telecom>
<system value="url"/>
<value value="https://www.lugpa.org/"/>
</telecom>
</author>
<relatedArtifact>
<type value="citation"/>
<citation
value="D'Silva, K. A., Dahm, P., \& Wong, C. L. (2014). Does this man with lower urinary tract symptoms have bladder outlet obstruction? The Rational Clinical Examination: A systematic review. Journal of the American Medical Association, 312(5), 535-542. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25096693
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="McVary, K. T., Roehrborn, C. G., Avins, A. L., et al. (2014). Management of benign prostatic hyperplasia. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21420124/
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Medina, J. J., Parra, R. O., \& Moore, R. G. (1999). Benign prostatic hyperplasia (the aging prostate). Medical Clinics of North America, 83(5), 1213-1229. Retrieved from http://www.sciencedirect.com/science/article/pii/S0025712505701590
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="O'Leary, M. P. (2005). Validity of the Bother Score in the evaluation and treatment of symptomatic benign prostatic hyperplasia. Reviews in Urology, 7(1), 1-10. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477553/
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Wei, J., Calhoun, E., \& Jacobsen, S. (2005). Urologic diseases in America project: Benign prostatic hyperplasia. Journal of Urology, 173(4), 1256-1261. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15758764
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Wuerstle, M. C., Van Den Eeden, S. K., Poon, K. T., et al. (2011). Contribution of common medications to lower urinary tract symptoms in men. Archives of Internal Medicine, 171(18), 1680-1682. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21987200
"/>
</relatedArtifact>
<library
value="https://madie.cms.gov/Library/CMS771FHIRUrinarySymptomScoreBPH"/>
<disclaimer
value="The performance measure is not a clinical guideline and 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 \[TM\].
"/>
<rationale
value="Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting older males, with a prevalence of 50% by age 60 years and 90% by the ninth decade of life (Medina et al., 1999). The enlarged gland had been proposed to contribute to the overall lower urinary tract symptoms (LUTS) complex (McVary et al., 2014). Although LUTS secondary to BPH is not often a life-threatening condition, the impact of LUTS/BPH on quality of life can be significant (Wei et al., 2005). The American Urological Association Symptom Index (AUA-SI) and the International Prostate Symptom Score (IPSS) were developed to measure outcomes in studies of different treatments for BPH (Wuerstle et al., 2011). The IPSS uses the same questions as the AUA-SI, but also adds a disease-specific Quality of Life (QOL) score question (O'Leary, 2005). The IPSS was adopted in 1993 by the World Health Organization. It is a reproducible, validated index designed to determine disease severity and response to therapy (D'Silva et al., 2014). It includes 3 storage symptom questions (frequency, nocturia, urgency) and four voiding symptoms (feeling of incomplete emptying, intermittency, straining, and a weak stream) as well as a Bother question: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? A three-point improvement in the score is considered meaningful (McVary et al., 2014).
"/>
<clinicalRecommendationStatement
value="The symptoms of BPH are lower urinary tract symptoms (LUTS). There are other disorders with similar symptoms that need to be excluded. History, physical examination, and testing are required prior to a diagnosis of BPH. IPSS by itself is not a reliable diagnostic tool for LUTS suggestive of BPH but serves as a quantitative measure of LUTS after the diagnosis is established (D'Silva et al., 2014). Medical and surgical interventions for BPH recommend a follow up IPSS evaluation to determine effectiveness of treatment. IPSS should be evaluated at the time of diagnosis and after definitive treatment.
"/>
<group id="Group_1">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueString value="None
"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-improvementNotationGuidance">
<valueMarkdown
value="A meaningful improvement is a negative 3-point change in the urinary symptom score. The quality improves when a higher proportion of people meet the meaningful improvement definition.
"/>
</extension>
<population id="InitialPopulation_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to the measurement period who had a qualifying visit during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="Denominator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description
value="Patients in the Initial Population with a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="DenominatorExclusion_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Patients with urinary retention that starts within 1 year of initial BPH diagnosis. Patients with an initial BPH diagnosis that starts during, or within 30 days after end of hospitalization.
Patients with a diagnosis of morbid obesity, or with a BMI Exam \>=40 before the follow up urinary symptom score.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>