Id: OpioidCDSREC10OrderSignCRD Url: OpioidCDSREC10OrderSignCRD Version: 2022.1.0 Name: OpioidCDSREC10OrderSignCRD Status: draft Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2025-11-13 15:52:38+0000 Publisher: Centers for Disease Control and Prevention (CDC) Related Artifacts: Dependencies http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1 http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1 Parameters: Name Type Min Max In/Out ContextPrescriptions MedicationRequest 0 * In Patient Patient 0 1 Out Do the CRD thing? boolean 0 1 Out Get Coverage Extension Extension 0 1 Out Data Requirements: Type Profile MS Code Filter Patient http://hl7.org/fhir/StructureDefinition/Patient Content: text/cql library OpioidCDSREC10OrderSignCRD version '2022.1.0' using FHIR version '4.0.1' include FHIRHelpers version '4.0.1' called FHIRHelpers /* ** Recommendation #10 ** When prescribing opioids for subacute or chronic pain, clinicians should consider the benefits ** and risks of toxicology testing to assess for prescribed medications as well as other prescribed ** and nonprescribed controlled substances (recommendation category: B; evidence type: 4). ** ** When ** Provider is prescribing an opioid analgesic with ambulatory misuse potential in the outpatient setting: ** Prescription is for treating subacute and/or chronic pain. ** Opioid review is useful for this patient: ** Patient is 18 or over ** Patient does not have evidence of sickle cell disease ** Patient does not have findings indicating limited life expectancy ** Patient does not have orders for therapies indicating end of life care ** Patient is not undergoing active cancer treatment: ** Patient has had at least 2 office visits within the past 12 months with an oncology specialist present, or ** Patient has had at least 2 office visits within the past 12 months with a CDC malignant cancer condition diagnosis ** Patient does not have conditions likely terminal for opioid prescribing present ** Nonopioid drug urine screening has not been performed in last 12 months or ** Opioid drug urine screening has not been performed in last 12 months ** Then ** Consider the benefits and risks of conducting a urine toxicology screen: ** Document - Order toxicology screen ** Document risks outweigh benefits ** Snooze - N/A see comment, snooze 3 months ** When ** Provider is prescribing an opioid analgesic with ambulatory misuse potential in the outpatient setting: ** Prescription is for treating subacute and/or chronic pain. ** Opioid review is useful for this patient: ** Patient is 18 or over ** Patient does not have evidence of sickle cell disease ** Patient does not have findings indicating limited life expectancy ** Patient does not have orders for therapies indicating end of life care ** Patient is not undergoing active cancer treatment: ** Patient has had at least 2 office visits within the past 12 months with an oncology specialist present, or ** Patient has had at least 2 office visits within the past 12 months with a CDC malignant cancer condition diagnosis ** Patient does not have conditions likely terminal for opioid prescribing present ** Nonopioid drug urine screening has been performed in last 12 months and ** Opioid drug urine screening has been performed in last 12 months and ** Positive result for synthetic opioid in the past year and not currently prescribed synthetic opioid or ** Positive result for phencyclidine(PCP) in the past year or ** Positive result for fentanyl in the past year and not currently prescribed fentanyl or ** Positive result for cocaine in the past year or ** Positive result for amphetamine in the past year and not currently prescribed amphetamine or ** Positive result for tetrahydrocannabinol (THC) in the past year and not currently prescribed tetrahydrocannabinol (THC) or ** Positive result for opiate in the past year and not currently prescribed natural opiate or ** Positive result for alcohol in the past year or ** Positive result for methadone in the past year and not currently prescribed methadone ** Then ** Patient may have unexpected toxicology test results: ** Document - Will repeat urine drug screening more frequently ** Document - Will assess patient for substance use disorder ** Snooze - Patient's test results were expected, snooze for 3 months ** Snooze - N/A snooze for 3 months ** */ // META: Plan Definition: http://fhir.org/guides/cdc/opioid-cds-r4/PlanDefinition/opioid-cds-10-order-sign parameter ContextPrescriptions List&lt;MedicationRequest&gt; context Patient define &quot;Do the CRD thing?&quot;: true define &quot;Get Coverage Extension&quot;: FHIR.Extension { url: FHIR.url { value: 'http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information' }, extension: { FHIR.Extension { url: FHIR.url { value: 'coverage' }, value: FHIR.Reference { reference: FHIR.string { value: 'http://example.org/fhir/Coverage/example' } } }, FHIR.Extension { url: FHIR.url { value: 'covered' }, value: FHIR.code { value: 'covered' } }, FHIR.Extension { url: FHIR.url { value: 'pa-needed' }, value: FHIR.code { value: 'satisfied' } }, FHIR.Extension { url: FHIR.url { value: 'billingCode' }, value: FHIR.Coding { system: FHIR.uri { value: 'http://www.ama-assn.org/go/cpt' }, code: FHIR.code { value: '77065' } } }, FHIR.Extension { url: FHIR.url { value: 'billingCode' }, value: FHIR.Coding { system: FHIR.uri { value: 'http://www.ama-assn.org/go/cpt' }, code: FHIR.code { value: '77066' } } }, FHIR.Extension { url: FHIR.url { value: 'billingCode' }, value: FHIR.Coding { system: FHIR.uri { value: 'http://www.ama-assn.org/go/cpt' }, code: FHIR.code { value: '77067' } } }, FHIR.Extension { url: FHIR.url { value: 'reason' }, value: FHIR.CodeableConcept { text: FHIR.string { value: 'In-network required unless exigent circumstances' } } } } } Content: application/elm+xml Encoded data (89572 characters) Content: application/elm+json Encoded data (165120 characters)
Centers for Disease Control and Prevention (CDC)