eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-12-18 |
<Measure xmlns="http://hl7.org/fhir">
<id value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
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<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Functional Status Assessment for Total Hip ReplacementFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.0.008</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-FunctionalStatusAssessmentforTotalHipReplacementFHIR.html">Functional Status Assessment for Total Hip ReplacementFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS56FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:959c21c9-35c7-4967-aaec-3dab54850811</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:ebd41a01-4e61-4198-9ff0-becc43de1ba7</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>56FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2025-01-01..2025-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Centers for Medicare & Medicaid Services (CMS)</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">National Committee for Quality Assurance</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. The American Dental Association (“ADA”) holds a copyright to the Current Dental Terminology (“CDT”) codes contained in certain measure specifications. The CDT codes in the measure specifications are included with the permission of the ADA. All uses of the CDT codes require a license from the ADA. No alteration, amendments, or modifications of the CDT or any portion thereof is allowed. Resale, transmission, or distribution of copies of the CDT or other portions of the CDT is also not allowed. To inquire about licensing, contact CDT-SNODENT@ada.org. The measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. “HL7” is the registered trademark of Health Level Seven International.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><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. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Proportion </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>THAs are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for older adults, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006). This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock et al., 2010).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">The same FSA instrument must be used for the initial and follow-up assessment. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS56v13. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>64e6505f2ad653247b573ae2</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Equals Initial Population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after.</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-FunctionalStatusAssessmentforTotalHipReplacementFHIR.html">FunctionalStatusAssessmentforTotalHipReplacementFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/Status|1.8.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/Hospice|6.12.000</code></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html">Observation Category Codes</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-CPT.html">Current Procedural Terminology (CPT®)</a></li>
<li><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1006/expansion">Primary THA Procedure</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion">Outpatient Consultation</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1178/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1178</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1184/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1184</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1189/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1189</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1180/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1180</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1182/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1182</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Denominator Exclusions</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Hospice Care Ambulatory
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Partial Arthroplasty of Hip
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1184/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1184</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Removal, Revision and Supplement Procedures of the Lower Body and Spine
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1189/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1189</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
id
id.value
performed
status
status.value
</td>
<td>
Primary THA Procedure
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1006/expansion">Primary THA Procedure</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
id
id.value
status
status.value
</td>
<td>
Primary THA Procedure
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1006/expansion">Primary THA Procedure</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Primary THA Procedure
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1006/expansion">Primary THA Procedure</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
category
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Outpatient Consultation
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion">Outpatient Consultation</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Office Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Telephone Visits
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Virtual Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
hospitalization
hospitalization.dischargeDisposition
period
status
status.value
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Hospice Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
authoredOn
authoredOn.value
status
status.value
intent
intent.value
</td>
<td>
Hospice Care Ambulatory
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Hospice Diagnosis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Lower Body Fractures Excluding Ankle and Foot
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1178/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1178</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Malignant Neoplasms of Lower and Unspecified Limbs
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1180/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1180</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Mechanical Complications Excluding Upper Body
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1182/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1182</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>survey</td>
<td>survey</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html">http://terminology.hl7.org/CodeSystem/observation-category</a></td>
</tr>
<tr>
<td>Quality of life score [HOOS]</td>
<td>72093-8</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Sport-recreation score [HOOS]</td>
<td>72094-6</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Activities of daily living score [HOOS]</td>
<td>72095-3</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Symptoms score [HOOS]</td>
<td>72096-1</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Pain score [HOOS]</td>
<td>72097-9</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Total interval score [HOOSJR]</td>
<td>82323-7</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>PROMIS-10 Global Mental Health (GMH) score T-score</td>
<td>71969-0</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>PROMIS-10 Global Physical Health (GPH) score T-score</td>
<td>71971-6</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>VR-12 Mental component summary (MCS) score - oblique method T-score</td>
<td>72026-8</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>VR-12 Physical component summary (PCS) score - oblique method T-score</td>
<td>72025-0</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>VR-12 Mental component summary (MCS) score - orthogonal method T-score</td>
<td>72028-4</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>VR-12 Physical component summary (PCS) score - orthogonal method T-score</td>
<td>72027-6</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure</td>
<td>99024</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-CPT.html">http://www.ama-assn.org/go/cpt</a></td>
</tr>
<tr>
<td>Discharge to home for hospice care (procedure)</td>
<td>428361000124107</td>
<td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Discharge to healthcare facility for hospice care (procedure)</td>
<td>428371000124100</td>
<td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Yes (qualifier value)</td>
<td>373066001</td>
<td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Hospice care [Minimum Data Set]</td>
<td>45755-6</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Severe cognitive impairment (finding)</td>
<td>702956004</td>
<td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 64e6505f2ad653247b573ae2 </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<b>Measure scoring:</b>
<p style="margin-bottom: 5px;">
<span>Proportion</span>
</p>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<td colspan="3" style="padding-left: 4px;">None</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>increase </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
"Has Qualifying Encounter"
and exists ( "Total Hip Arthroplasty Procedure" )
and AgeInYearsAt(date from start of "Measurement Period") >= 19</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusions":
Hospice."Has Hospice Services"
or "Has Severe Cognitive Impairment"
or "Has Total Hip Arthroplasty with 1 or More Lower Body Fractures"
or "Has Partial Hip Arthroplasty Procedure"
or "Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure"
or "Has Malignant Neoplasm of Lower and Unspecified Limbs"
or "Has Mechanical Complication"
or "Has More Than One Elective Primary Total Hip Arthroplasty Performed"
or "Death Within 300 Days of the THA Procedure"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
( "Has THA with Initial and Follow Up HOOS Assessments" )
or ( "Has THA with Initial and Follow Up HOOSJr Assessments" )
or ( "Has THA with Initial and Follow Up PROMIS10 Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Oblique Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Orthogonal Assessments" )</code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>November 1 Two Years Prior to the Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "November 1 Two Years Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 2), 11, 1, 0, 0, 0, 0, 0)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>October 31 Year Prior to the Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "October 31 Year Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 1), 10, 31, 23, 59, 59, 0, 0)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Total Hip Arthroplasty Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Total Hip Arthroplasty Procedure":
( ( [Procedure: "Primary THA Procedure"] ).isProcedurePerformed ( ) ) THAProcedure
where THAProcedure.performed.toInterval ( ) starts during day of Interval["November 1 Two Years Prior to the Measurement Period", "October 31 Year Prior to the Measurement Period"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Date HOOS Total Assessment Completed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Date HOOS Total Assessment Completed":
from
( ( [Observation: "Quality of life score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSLifeQuality,
( ( [Observation: "Sport-recreation score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSSport,
( ( [Observation: "Activities of daily living score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSActivityScore,
( ( [Observation: "Symptoms score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSSymptoms,
( ( [Observation: "Pain score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSPain
let HOOSLifeQualityDate: date from start of HOOSLifeQuality.effective.toInterval ( ),
HOOSSportDate: date from start of HOOSSport.effective.toInterval ( ),
HOOSActivityScoreDate: date from start of HOOSActivityScore.effective.toInterval ( ),
HOOSSymptomsDate: date from start of HOOSSymptoms.effective.toInterval ( ),
HOOSPainDate: date from start of HOOSPain.effective.toInterval ( )
where HOOSLifeQualityDate same day as HOOSSportDate
and HOOSSport.value is not null
and HOOSLifeQualityDate same day as HOOSActivityScoreDate
and HOOSActivityScore.value is not null
and HOOSLifeQualityDate same day as HOOSSymptomsDate
and HOOSSymptoms.value is not null
and HOOSLifeQualityDate same day as HOOSPainDate
and HOOSPain.value is not null
and HOOSLifeQuality.value is not null
return Max({ HOOSLifeQualityDate, HOOSSportDate, HOOSActivityScoreDate, HOOSSymptomsDate, HOOSPainDate })</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has THA with Initial and Follow Up HOOS Assessments</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has THA with Initial and Follow Up HOOS Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date HOOS Total Assessment Completed" InitialHipAssessmentHOOS
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentHOOS
with "Date HOOS Total Assessment Completed" FollowUpHipAssessmentHOOS
such that date from FollowUpHipAssessmentHOOS during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Date HOOSJr Total Assessment Completed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Date HOOSJr Total Assessment Completed":
( ( ( [Observation: "Total interval score [HOOSJR]"] ).isAssessmentPerformed ( ) ) HOOSJr
where HOOSJr.value is not null ) DocumentedHOOSJr
return date from start of DocumentedHOOSJr.effective.toInterval ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has THA with Initial and Follow Up HOOSJr Assessments</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has THA with Initial and Follow Up HOOSJr Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date HOOSJr Total Assessment Completed" InitialHipAssessment
such that TotalHip starts 90 days or less on or after day of InitialHipAssessment
with "Date HOOSJr Total Assessment Completed" FollowUpHipAssessment
such that date from FollowUpHipAssessment during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Date PROMIS10 Total Assessment Completed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Date PROMIS10 Total Assessment Completed":
from
( ( [Observation: "PROMIS-10 Global Mental Health (GMH) score T-score"] ).isAssessmentPerformed ( ) ) PROMIS10MentalScore,
( ( [Observation: "PROMIS-10 Global Physical Health (GPH) score T-score"] ).isAssessmentPerformed ( ) ) PROMIS10PhysicalScore
let PROMIS10MentalScoreDate: date from start of PROMIS10MentalScore.effective.toInterval ( ),
PROMIS10PhysicalScoreDate: date from start of PROMIS10PhysicalScore.effective.toInterval ( )
where PROMIS10MentalScoreDate same day as PROMIS10PhysicalScoreDate
and PROMIS10PhysicalScore.value is not null
and PROMIS10MentalScore.value is not null
return Max({ PROMIS10MentalScoreDate, PROMIS10PhysicalScoreDate })</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has THA with Initial and Follow Up PROMIS10 Assessments</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has THA with Initial and Follow Up PROMIS10 Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date PROMIS10 Total Assessment Completed" InitialHipAssessmentPROMIS10
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentPROMIS10
with "Date PROMIS10 Total Assessment Completed" FollowUpHipAssessmentPROMIS10
such that date from FollowUpHipAssessmentPROMIS10 during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Date VR12 Oblique Total Assessment Completed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Date VR12 Oblique Total Assessment Completed":
from
( ( [Observation: "VR-12 Mental component summary (MCS) score - oblique method T-score"] ).isAssessmentPerformed ( ) ) VR12MentalAssessment,
( ( [Observation: "VR-12 Physical component summary (PCS) score - oblique method T-score"] ).isAssessmentPerformed ( ) ) VR12PhysicalAssessment
let VR12MentalAssessmentDate: date from start of VR12MentalAssessment.effective.toInterval ( ),
VR12PhysicalAssessmentDate: date from start of VR12PhysicalAssessment.effective.toInterval ( )
where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
and VR12MentalAssessment.value is not null
and VR12PhysicalAssessment.value is not null
return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has THA with Initial and Follow Up VR12 Oblique Assessments</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has THA with Initial and Follow Up VR12 Oblique Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date VR12 Oblique Total Assessment Completed" InitialHipAssessmentOblique
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentOblique
with "Date VR12 Oblique Total Assessment Completed" FollowUpHipAssessmentOblique
such that date from FollowUpHipAssessmentOblique during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Date VR12 Orthogonal Total Assessment Completed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Date VR12 Orthogonal Total Assessment Completed":
from
( ( [Observation: "VR-12 Mental component summary (MCS) score - orthogonal method T-score"] ).isAssessmentPerformed ( ) ) VR12MentalAssessment,
( ( [Observation: "VR-12 Physical component summary (PCS) score - orthogonal method T-score"] ).isAssessmentPerformed ( ) ) VR12PhysicalAssessment
let VR12MentalAssessmentDate: date from start of VR12MentalAssessment.effective.toInterval ( ),
VR12PhysicalAssessmentDate: date from start of VR12PhysicalAssessment.effective.toInterval ( )
where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
and VR12MentalAssessment.value is not null
and VR12PhysicalAssessment.value is not null
return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has THA with Initial and Follow Up VR12 Orthogonal Assessments</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has THA with Initial and Follow Up VR12 Orthogonal Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date VR12 Orthogonal Total Assessment Completed" InitialHipAssessmentOrthogonal
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentOrthogonal
with "Date VR12 Orthogonal Total Assessment Completed" FollowUpHipAssessmentOrthogonal
such that date from FollowUpHipAssessmentOrthogonal during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
( "Has THA with Initial and Follow Up HOOS Assessments" )
or ( "Has THA with Initial and Follow Up HOOSJr Assessments" )
or ( "Has THA with Initial and Follow Up PROMIS10 Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Oblique Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Orthogonal Assessments" )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>August 1 Year Prior to the Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "August 1 Year Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 1), 8, 1, 0, 0, 0, 0, 0)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Qualifying Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Qualifying Encounter":
exists ( ( ( [Encounter: "Outpatient Consultation"]
union [Encounter: "Office Visit"]
union ( [Encounter] E
where exists ( ( E.type ) T
where T ~ "Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure"
)
)
union [Encounter: "Telephone Visits"]
union [Encounter: "Virtual Encounter"]
).isEncounterPerformed ( ) ) ValidEncounters
where ValidEncounters.period.toInterval ( ) during day of Interval["August 1 Year Prior to the Measurement Period", end of "Measurement Period"]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
"Has Qualifying Encounter"
and exists ( "Total Hip Arthroplasty Procedure" )
and AgeInYearsAt(date from start of "Measurement Period") >= 19</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Hospice</td>
<td>Has Hospice Services</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Hospice Services":
exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and InpatientEncounter.period.toInterval() ends during day of "Measurement Period"
)
or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
where HospiceAssessment.value ~ "Yes (qualifier value)"
and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period"
// and HospiceOrder.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)
or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
)
or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis
where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Severe Cognitive Impairment</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Severe Cognitive Impairment":
exists [Condition: "Severe cognitive impairment (finding)"] Dementia
where Dementia.prevalenceInterval ( ) overlaps day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Total Hip Arthroplasty with 1 or More Lower Body Fractures</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Total Hip Arthroplasty with 1 or More Lower Body Fractures":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with [Condition: "Lower Body Fractures Excluding Ankle and Foot"] LowerBodyFracture
such that LowerBodyFracture.prevalenceInterval ( ) starts 24 hours or less on or before start of THAProcedure.performed."toInterval" ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Partial Hip Arthroplasty Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Partial Hip Arthroplasty Procedure":
exists ( ( ( [Procedure: "Partial Arthroplasty of Hip"] ).isProcedurePerformed ( ) ) PartialTHAProcedure
with "Total Hip Arthroplasty Procedure" THAProcedure
such that PartialTHAProcedure.performed.toInterval ( ) during day of THAProcedure.performed.toInterval ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with ( ( [Procedure: "Removal, Revision and Supplement Procedures of the Lower Body and Spine"] ).isProcedurePerformed ( ) ) RevisionTHAProcedure
such that RevisionTHAProcedure.performed.toInterval ( ) during day of THAProcedure.performed.toInterval ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Malignant Neoplasm of Lower and Unspecified Limbs</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Malignant Neoplasm of Lower and Unspecified Limbs":
exists ( [Condition: "Malignant Neoplasms of Lower and Unspecified Limbs"] MalignantNeoplasm
with "Total Hip Arthroplasty Procedure" THAProcedure
such that MalignantNeoplasm.prevalenceInterval ( ) overlaps day of THAProcedure.performed.toInterval ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has Mechanical Complication</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Mechanical Complication":
exists ( [Condition: "Mechanical Complications Excluding Upper Body"] MechanicalComplications
with "Total Hip Arthroplasty Procedure" THAProcedure
such that MechanicalComplications.prevalenceInterval ( ) overlaps day of THAProcedure.performed.toInterval ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Has More Than One Elective Primary Total Hip Arthroplasty Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has More Than One Elective Primary Total Hip Arthroplasty Performed":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with ( ( [Procedure: "Primary THA Procedure"] ).isProcedurePerformed ( ) ) ElectiveTHAProcedure
such that THAProcedure.id !~ ElectiveTHAProcedure.id
and start of ElectiveTHAProcedure.performed.toInterval ( ) during day of Interval[( start of THAProcedure.performed.toInterval ( ) ) - 1 year, ( start of THAProcedure.performed.toInterval ( ) ) + 1 year]
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Death Within 300 Days of the THA Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Death Within 300 Days of the THA Procedure":
exists "Total Hip Arthroplasty Procedure" THAProcedure
where date from Patient.deceased during day of Interval[date from start of THAProcedure.performed.toInterval ( ), date from start of THAProcedure.performed.toInterval ( ) + 300 days]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FunctionalStatusAssessmentforTotalHipReplacementFHIR</td>
<td>Denominator Exclusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
Hospice."Has Hospice Services"
or "Has Severe Cognitive Impairment"
or "Has Total Hip Arthroplasty with 1 or More Lower Body Fractures"
or "Has Partial Hip Arthroplasty Procedure"
or "Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure"
or "Has Malignant Neoplasm of Lower and Unspecified Limbs"
or "Has Mechanical Complication"
or "Has More Than One Elective Primary Total Hip Arthroplasty Performed"
or "Death Within 300 Days of the THA Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isProcedurePerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Procedure, Performed
define fluent function isProcedurePerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isAssessmentPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.
//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "survey"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToConcept</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isEncounterPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>toInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isInterventionOrder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Intervention, Order: active and completed only
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent = 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isInterventionPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>prevalenceInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
(end of condition.abatementInterval()) abatementDate
return if abatementDate is null then
Interval[start of condition.onset.toInterval(), abatementDate)
else
Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="survey"/>
<display value="survey"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72093-8"/>
<display value="Quality of life score [HOOS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72094-6"/>
<display value="Sport-recreation score [HOOS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72095-3"/>
<display value="Activities of daily living score [HOOS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72096-1"/>
<display value="Symptoms score [HOOS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72097-9"/>
<display value="Pain score [HOOS]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="82323-7"/>
<display value="Total interval score [HOOSJR]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="71969-0"/>
<display
value="PROMIS-10 Global Mental Health (GMH) score T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="71971-6"/>
<display
value="PROMIS-10 Global Physical Health (GPH) score T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72026-8"/>
<display
value="VR-12 Mental component summary (MCS) score - oblique method T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72025-0"/>
<display
value="VR-12 Physical component summary (PCS) score - oblique method T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72028-4"/>
<display
value="VR-12 Mental component summary (MCS) score - orthogonal method T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72027-6"/>
<display
value="VR-12 Physical component summary (PCS) score - orthogonal method T-score"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="99024"/>
<display
value="Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428361000124107"/>
<display value="Discharge to home for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428371000124100"/>
<display
value="Discharge to healthcare facility for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="373066001"/>
<display value="Yes (qualifier value)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="702956004"/>
<display value="Severe cognitive impairment (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="November 1 Two Years Prior to the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "November 1 Two Years Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 2), 11, 1, 0, 0, 0, 0, 0)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="October 31 Year Prior to the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "October 31 Year Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 1), 10, 31, 23, 59, 59, 0, 0)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Total Hip Arthroplasty Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Total Hip Arthroplasty Procedure":
( ( [Procedure: "Primary THA Procedure"] ).isProcedurePerformed ( ) ) THAProcedure
where THAProcedure.performed.toInterval ( ) starts during day of Interval["November 1 Two Years Prior to the Measurement Period", "October 31 Year Prior to the Measurement Period"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Date HOOS Total Assessment Completed"/>
</extension>
<extension url="statement">
<valueString
value="define "Date HOOS Total Assessment Completed":
from
( ( [Observation: "Quality of life score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSLifeQuality,
( ( [Observation: "Sport-recreation score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSSport,
( ( [Observation: "Activities of daily living score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSActivityScore,
( ( [Observation: "Symptoms score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSSymptoms,
( ( [Observation: "Pain score [HOOS]"] ).isAssessmentPerformed ( ) ) HOOSPain
let HOOSLifeQualityDate: date from start of HOOSLifeQuality.effective.toInterval ( ),
HOOSSportDate: date from start of HOOSSport.effective.toInterval ( ),
HOOSActivityScoreDate: date from start of HOOSActivityScore.effective.toInterval ( ),
HOOSSymptomsDate: date from start of HOOSSymptoms.effective.toInterval ( ),
HOOSPainDate: date from start of HOOSPain.effective.toInterval ( )
where HOOSLifeQualityDate same day as HOOSSportDate
and HOOSSport.value is not null
and HOOSLifeQualityDate same day as HOOSActivityScoreDate
and HOOSActivityScore.value is not null
and HOOSLifeQualityDate same day as HOOSSymptomsDate
and HOOSSymptoms.value is not null
and HOOSLifeQualityDate same day as HOOSPainDate
and HOOSPain.value is not null
and HOOSLifeQuality.value is not null
return Max({ HOOSLifeQualityDate, HOOSSportDate, HOOSActivityScoreDate, HOOSSymptomsDate, HOOSPainDate })"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has THA with Initial and Follow Up HOOS Assessments"/>
</extension>
<extension url="statement">
<valueString
value="define "Has THA with Initial and Follow Up HOOS Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date HOOS Total Assessment Completed" InitialHipAssessmentHOOS
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentHOOS
with "Date HOOS Total Assessment Completed" FollowUpHipAssessmentHOOS
such that date from FollowUpHipAssessmentHOOS during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Date HOOSJr Total Assessment Completed"/>
</extension>
<extension url="statement">
<valueString
value="define "Date HOOSJr Total Assessment Completed":
( ( ( [Observation: "Total interval score [HOOSJR]"] ).isAssessmentPerformed ( ) ) HOOSJr
where HOOSJr.value is not null ) DocumentedHOOSJr
return date from start of DocumentedHOOSJr.effective.toInterval ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has THA with Initial and Follow Up HOOSJr Assessments"/>
</extension>
<extension url="statement">
<valueString
value="define "Has THA with Initial and Follow Up HOOSJr Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date HOOSJr Total Assessment Completed" InitialHipAssessment
such that TotalHip starts 90 days or less on or after day of InitialHipAssessment
with "Date HOOSJr Total Assessment Completed" FollowUpHipAssessment
such that date from FollowUpHipAssessment during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Date PROMIS10 Total Assessment Completed"/>
</extension>
<extension url="statement">
<valueString
value="define "Date PROMIS10 Total Assessment Completed":
from
( ( [Observation: "PROMIS-10 Global Mental Health (GMH) score T-score"] ).isAssessmentPerformed ( ) ) PROMIS10MentalScore,
( ( [Observation: "PROMIS-10 Global Physical Health (GPH) score T-score"] ).isAssessmentPerformed ( ) ) PROMIS10PhysicalScore
let PROMIS10MentalScoreDate: date from start of PROMIS10MentalScore.effective.toInterval ( ),
PROMIS10PhysicalScoreDate: date from start of PROMIS10PhysicalScore.effective.toInterval ( )
where PROMIS10MentalScoreDate same day as PROMIS10PhysicalScoreDate
and PROMIS10PhysicalScore.value is not null
and PROMIS10MentalScore.value is not null
return Max({ PROMIS10MentalScoreDate, PROMIS10PhysicalScoreDate })"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has THA with Initial and Follow Up PROMIS10 Assessments"/>
</extension>
<extension url="statement">
<valueString
value="define "Has THA with Initial and Follow Up PROMIS10 Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date PROMIS10 Total Assessment Completed" InitialHipAssessmentPROMIS10
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentPROMIS10
with "Date PROMIS10 Total Assessment Completed" FollowUpHipAssessmentPROMIS10
such that date from FollowUpHipAssessmentPROMIS10 during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Date VR12 Oblique Total Assessment Completed"/>
</extension>
<extension url="statement">
<valueString
value="define "Date VR12 Oblique Total Assessment Completed":
from
( ( [Observation: "VR-12 Mental component summary (MCS) score - oblique method T-score"] ).isAssessmentPerformed ( ) ) VR12MentalAssessment,
( ( [Observation: "VR-12 Physical component summary (PCS) score - oblique method T-score"] ).isAssessmentPerformed ( ) ) VR12PhysicalAssessment
let VR12MentalAssessmentDate: date from start of VR12MentalAssessment.effective.toInterval ( ),
VR12PhysicalAssessmentDate: date from start of VR12PhysicalAssessment.effective.toInterval ( )
where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
and VR12MentalAssessment.value is not null
and VR12PhysicalAssessment.value is not null
return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has THA with Initial and Follow Up VR12 Oblique Assessments"/>
</extension>
<extension url="statement">
<valueString
value="define "Has THA with Initial and Follow Up VR12 Oblique Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date VR12 Oblique Total Assessment Completed" InitialHipAssessmentOblique
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentOblique
with "Date VR12 Oblique Total Assessment Completed" FollowUpHipAssessmentOblique
such that date from FollowUpHipAssessmentOblique during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Date VR12 Orthogonal Total Assessment Completed"/>
</extension>
<extension url="statement">
<valueString
value="define "Date VR12 Orthogonal Total Assessment Completed":
from
( ( [Observation: "VR-12 Mental component summary (MCS) score - orthogonal method T-score"] ).isAssessmentPerformed ( ) ) VR12MentalAssessment,
( ( [Observation: "VR-12 Physical component summary (PCS) score - orthogonal method T-score"] ).isAssessmentPerformed ( ) ) VR12PhysicalAssessment
let VR12MentalAssessmentDate: date from start of VR12MentalAssessment.effective.toInterval ( ),
VR12PhysicalAssessmentDate: date from start of VR12PhysicalAssessment.effective.toInterval ( )
where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
and VR12MentalAssessment.value is not null
and VR12PhysicalAssessment.value is not null
return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has THA with Initial and Follow Up VR12 Orthogonal Assessments"/>
</extension>
<extension url="statement">
<valueString
value="define "Has THA with Initial and Follow Up VR12 Orthogonal Assessments":
exists ( ( "Total Hip Arthroplasty Procedure" THAProcedure
return THAProcedure.performed.toInterval ( ) ) TotalHip
with "Date VR12 Orthogonal Total Assessment Completed" InitialHipAssessmentOrthogonal
such that TotalHip starts 90 days or less on or after day of InitialHipAssessmentOrthogonal
with "Date VR12 Orthogonal Total Assessment Completed" FollowUpHipAssessmentOrthogonal
such that date from FollowUpHipAssessmentOrthogonal during day of Interval[date from end of TotalHip + 300 days, date from end of TotalHip + 425 days]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
( "Has THA with Initial and Follow Up HOOS Assessments" )
or ( "Has THA with Initial and Follow Up HOOSJr Assessments" )
or ( "Has THA with Initial and Follow Up PROMIS10 Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Oblique Assessments" )
or ( "Has THA with Initial and Follow Up VR12 Orthogonal Assessments" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="August 1 Year Prior to the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "August 1 Year Prior to the Measurement Period":
DateTime((year from start of "Measurement Period" - 1), 8, 1, 0, 0, 0, 0, 0)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Qualifying Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Qualifying Encounter":
exists ( ( ( [Encounter: "Outpatient Consultation"]
union [Encounter: "Office Visit"]
union ( [Encounter] E
where exists ( ( E.type ) T
where T ~ "Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure"
)
)
union [Encounter: "Telephone Visits"]
union [Encounter: "Virtual Encounter"]
).isEncounterPerformed ( ) ) ValidEncounters
where ValidEncounters.period.toInterval ( ) during day of Interval["August 1 Year Prior to the Measurement Period", end of "Measurement Period"]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
"Has Qualifying Encounter"
and exists ( "Total Hip Arthroplasty Procedure" )
and AgeInYearsAt(date from start of "Measurement Period") >= 19"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Hospice"/>
</extension>
<extension url="name">
<valueString value="Has Hospice Services"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Hospice Services":
exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and InpatientEncounter.period.toInterval() ends during day of "Measurement Period"
)
or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
where HospiceAssessment.value ~ "Yes (qualifier value)"
and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period"
// and HospiceOrder.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)
or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
)
or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis
where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Severe Cognitive Impairment"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Severe Cognitive Impairment":
exists [Condition: "Severe cognitive impairment (finding)"] Dementia
where Dementia.prevalenceInterval ( ) overlaps day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Total Hip Arthroplasty with 1 or More Lower Body Fractures"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Total Hip Arthroplasty with 1 or More Lower Body Fractures":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with [Condition: "Lower Body Fractures Excluding Ankle and Foot"] LowerBodyFracture
such that LowerBodyFracture.prevalenceInterval ( ) starts 24 hours or less on or before start of THAProcedure.performed."toInterval" ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Partial Hip Arthroplasty Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Partial Hip Arthroplasty Procedure":
exists ( ( ( [Procedure: "Partial Arthroplasty of Hip"] ).isProcedurePerformed ( ) ) PartialTHAProcedure
with "Total Hip Arthroplasty Procedure" THAProcedure
such that PartialTHAProcedure.performed.toInterval ( ) during day of THAProcedure.performed.toInterval ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with ( ( [Procedure: "Removal, Revision and Supplement Procedures of the Lower Body and Spine"] ).isProcedurePerformed ( ) ) RevisionTHAProcedure
such that RevisionTHAProcedure.performed.toInterval ( ) during day of THAProcedure.performed.toInterval ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Malignant Neoplasm of Lower and Unspecified Limbs"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Malignant Neoplasm of Lower and Unspecified Limbs":
exists ( [Condition: "Malignant Neoplasms of Lower and Unspecified Limbs"] MalignantNeoplasm
with "Total Hip Arthroplasty Procedure" THAProcedure
such that MalignantNeoplasm.prevalenceInterval ( ) overlaps day of THAProcedure.performed.toInterval ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Mechanical Complication"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Mechanical Complication":
exists ( [Condition: "Mechanical Complications Excluding Upper Body"] MechanicalComplications
with "Total Hip Arthroplasty Procedure" THAProcedure
such that MechanicalComplications.prevalenceInterval ( ) overlaps day of THAProcedure.performed.toInterval ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has More Than One Elective Primary Total Hip Arthroplasty Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Has More Than One Elective Primary Total Hip Arthroplasty Performed":
exists ( "Total Hip Arthroplasty Procedure" THAProcedure
with ( ( [Procedure: "Primary THA Procedure"] ).isProcedurePerformed ( ) ) ElectiveTHAProcedure
such that THAProcedure.id !~ ElectiveTHAProcedure.id
and start of ElectiveTHAProcedure.performed.toInterval ( ) during day of Interval[( start of THAProcedure.performed.toInterval ( ) ) - 1 year, ( start of THAProcedure.performed.toInterval ( ) ) + 1 year]
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Death Within 300 Days of the THA Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Death Within 300 Days of the THA Procedure":
exists "Total Hip Arthroplasty Procedure" THAProcedure
where date from Patient.deceased during day of Interval[date from start of THAProcedure.performed.toInterval ( ), date from start of THAProcedure.performed.toInterval ( ) + 300 days]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString
value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
Hospice."Has Hospice Services"
or "Has Severe Cognitive Impairment"
or "Has Total Hip Arthroplasty with 1 or More Lower Body Fractures"
or "Has Partial Hip Arthroplasty Procedure"
or "Has Revision Hip Arthroplasty Procedure or Implanted Device or Prosthesis Removal Procedure"
or "Has Malignant Neoplasm of Lower and Unspecified Limbs"
or "Has Mechanical Complication"
or "Has More Than One Elective Primary Total Hip Arthroplasty Performed"
or "Death Within 300 Days of the THA Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isProcedurePerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Procedure, Performed
define fluent function isProcedurePerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isAssessmentPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.
//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "survey"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isEncounterPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionOrder"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Order: active and completed only
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent = 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="prevalenceInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
(end of condition.abatementInterval()) abatementDate
return if abatementDate is null then
Interval[start of condition.onset.toInterval(), abatementDate)
else
Interval[start of condition.onset.toInterval(), abatementDate]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</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="Library Status"/>
<resource value="Library/Status|1.8.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Hospice"/>
<resource value="Library/Hospice|6.12.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ObservationCategoryCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
</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 CPT"/>
<resource value="http://www.ama-assn.org/go/cpt"/>
</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="Value set Primary THA Procedure"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1006"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Outpatient Consultation"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
</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 Telephone Visits"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Virtual Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Care Ambulatory"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Lower Body Fractures Excluding Ankle and Foot"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1178"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Partial Arthroplasty of Hip"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1184"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Removal, Revision and Supplement Procedures of the Lower Body and Spine"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1189"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Malignant Neoplasms of Lower and Unspecified Limbs"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1180"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Mechanical Complications Excluding Upper Body"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1182"/>
</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>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1184"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1189"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1006"/>
</codeFilter>
<dateFilter>
<path value="performed"/>
<valuePeriod>
<extension url="http://hl7.org/fhir/uv/crmi-analysisException">
<valueString
value="Error attempting to determine filter value: toFhirValue not implemented for Subtract"/>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement id="419">
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1006"/>
</codeFilter>
<dateFilter>
<path value="performed"/>
<valuePeriod>
<extension url="http://hl7.org/fhir/uv/crmi-analysisException">
<valueString
value="Error attempting to determine filter value: toFhirValue not implemented for ExpressionRef"/>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1006"/>
</codeFilter>
<dateFilter>
<path value="performed"/>
<valuePeriod>
<extension url="http://hl7.org/fhir/uv/crmi-analysisException">
<valueString
value="Error attempting to determine filter value: toFhirValue not implemented for ExpressionRef"/>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72093-8"/>
<display value="Quality of life score [HOOS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72094-6"/>
<display value="Sport-recreation score [HOOS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72095-3"/>
<display value="Activities of daily living score [HOOS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72096-1"/>
<display value="Symptoms score [HOOS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72097-9"/>
<display value="Pain score [HOOS]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="82323-7"/>
<display value="Total interval score [HOOSJR]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71969-0"/>
<display
value="PROMIS-10 Global Mental Health (GMH) score T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71971-6"/>
<display
value="PROMIS-10 Global Physical Health (GPH) score T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72026-8"/>
<display
value="VR-12 Mental component summary (MCS) score - oblique method T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72025-0"/>
<display
value="VR-12 Physical component summary (PCS) score - oblique method T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72028-4"/>
<display
value="VR-12 Mental component summary (MCS) score - orthogonal method T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="72027-6"/>
<display
value="VR-12 Physical component summary (PCS) score - orthogonal method T-score"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</code>
</codeFilter>
<codeFilter>
<path value="value"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<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="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</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/2.16.840.1.113883.3.464.1003.1003"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
<mustSupport value="code"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="702956004"/>
<display value="Severe cognitive impairment (finding)"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1178"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1180"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1182"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="https://madie.cms.gov/Measure/FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS56FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:959c21c9-35c7-4967-aaec-3dab54850811"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:ebd41a01-4e61-4198-9ff0-becc43de1ba7"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="56FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.0.008"/>
<name value="FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
<title value="Functional Status Assessment for Total Hip ReplacementFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2024-12-18T21:25:47+00:00"/>
<publisher value="Centers for Medicare & Medicaid Services (CMS)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</contact>
<description
value="Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery"/>
<purpose value="UNKNOWN"/>
<usage
value="The same FSA instrument must be used for the initial and follow-up assessment. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS56v13. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<copyright
value="This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. The American Dental Association (“ADA”) holds a copyright to the Current Dental Terminology (“CDT”) codes contained in certain measure specifications. The CDT codes in the measure specifications are included with the permission of the ADA. All uses of the CDT codes require a license from the ADA. No alteration, amendments, or modifications of the CDT or any portion thereof is allowed. Resale, transmission, or distribution of copies of the CDT or other portions of the CDT is also not allowed. To inquire about licensing, contact CDT-SNODENT@ada.org. The measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. “HL7” is the registered trademark of Health Level Seven International."/>
<effectivePeriod>
<start value="2025-01-01"/>
<end value="2025-12-31"/>
</effectivePeriod>
<author>
<name value="National Committee for Quality Assurance"/>
<telecom>
<system value="url"/>
<value value="https://www.ncqa.org/"/>
</telecom>
</author>
<library
value="https://madie.cms.gov/Library/FunctionalStatusAssessmentforTotalHipReplacementFHIR"/>
<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]."/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</scoring>
<rationale
value="THAs are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for older adults, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006). This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock et al., 2010)."/>
<clinicalRecommendationStatement
value="While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021)."/>
<group id="64e6505f2ad653247b573ae2">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode 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="decrease"/>
<display value="increase"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="4EA9E89B-B825-47DB-8554-34FC0111A0EC">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="BE24FAE8-4176-44D7-A960-D8095FC92A1E">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="F33F0D3F-E62F-4144-949C-82C7C9384AE4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="D5C89190-6A94-414A-93E8-2AB0C621975B">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
</group>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
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