Metadata
Title | Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR
Version | 1.0.000
Short Name | CMS1154FHIR
GUID (Version Independent) | urn:uuid:d5fabe20-5aaa-4dea-bfb4-2fde59ea40d6
GUID (Version Specific) | urn:uuid:c116e4ae-6daf-49b2-b415-dd229215c674
CMS Identifier | 1154FHIR
Effective Period | 2026-01-01 through 2026-12-31
Use Context | org.hl7.fhir.r5.model.UsageContext@5f13e610
Steward (Publisher) | American Medical Association (AMA)
Developer | American Medical Association (AMA)
Developer | Health Services Advisory Group
Description | Percentage of adult patients with risk factors for type 2 diabetes who are due for glycemic screening for whom the screening process was completed during the measurement period.
Copyright | Prediabetes Quality Measures (C) 2018-2025. American Medical Association. All rights reserved. CPT (R) 2025 American Medical Association (“AMA”). All rights reserved. You cannot, without express written permission from the AMA, copy, modify, distribute, display, or use CPT for any commercial purpose, including for productive use in a clinical setting. Any such use requires a separate license from the AMA. You agree that you shall not remove, obscure, or alter any proprietary rights notices (including copyright and trademark notices) which may be affixed to or contained within the measure. Current Procedural Terminology (CPT [R] code(s) (“CPT Codes”) information provided in the Measures is intended for reference and informational purposes only. Decisions regarding which CPT Code is appropriate must be made by physicians and/or their staff considering the clinical facts, circumstances, applicable coding and published AMA coding guideline and payor policies. The AMA does not dictate payer reimbursement policy and does not substitute for the professional judgment of the practitioner performing a procedure, who remains responsible for correct coding. The AMA is not engaged in the practice of medicine or dispensing medical services. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of the CPT code set, and the AMA is not recommending their use. Information contained in the measure includes information protected by intellectual property rights which are owned by the AMA. The Measures may also contain proprietary code sets not owned by the AMA. The AMA disclaims all liability for the use or accuracy of any such information. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC [R] copyright 2004-2025 Regenstrief Institute, Inc., SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2025, The International Health Information Standards Development Organisation (IHTSDO). ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.
Disclaimer | The Prediabetes Quality Measure set descriptions and specifications (collectively, “Measures”) are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures are not intended to diagnose or treat disease or other conditions. The Measures are not a medical device and have not been evaluated by the Food and Drug Administration. Information provided through the Measures is not intended to direct or substitute for the independent assessment or judgment of a qualified healthcare professional. The American Medical Association (“AMA”) assumes no liability for use of the Measures, or data contained or not contained in the Measures. The AMA consents to the use, reproduction and distribution of the Measures for non-commercial purposes only (e.g., for use by health care providers in a professional setting). You cannot, without the express written consent of the AMA, use the Measures for any commercial purpose. Unauthorized commercial use of the Measures is expressly prohibited. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed, or distributed for commercial gain. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable. To request to make a commercial use of the Measures, please email: AMA.IHO.QualityMeasures@ama-assn.org. Any commercial use of the Measures requires a separate license from the AMA. Any use, publication or other dissemination of these Measures shall include the following attribution: “This [publication, etc.] was prepared using clinical quality measures developed by the American Medical Association. The content reflects the views of [name of author(s)].” USE OF THE MEASURES (INCLUDING ANY CPT CODES) IS AT YOUR SOLE RISK. THE MEASURES ARE PROVIDED “AS IS” WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT. AMA EXPRESSLY DISCLAIMS ANY AND ALL RESPONSIBILITY OR LIABILITY FOR DAMAGES OF ANY KIND ARISING OUT OF USE, REFERENCE TO, OR RELIANCE ON THE MEAUSURES. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Rationale | This measure is critical to identifying patients with prediabetes who may benefit from interventions to prevent type 2 diabetes and identification of undiagnosed type 2 diabetes. The Centers for Disease Control and Prevention (CDC) estimates that approximately 97.6 million American adults have prediabetes (CDC, 2024). They note that more than 80% of adults with prediabetes are not aware that they have the condition. Regular screening for prediabetes is a critical first step to helping patients avoid the disability and costs associated with progression to type 2 diabetes. The measure gives credit for three types of tests that can be used to detect abnormal glucose metabolism: HbA1c, oral glucose tolerance, and fasting plasma glucose. When considering which plasma glucose screening codes to include in the measure, the measure development team carefully considered two potential unintended consequences related to the limited use of accompanying fasting status codes. If the measure specified plasma glucose screening too narrowly, it could incentivize over screening, which would impose added burden on clinicians and increased costs to some patients. Alternatively, if the measure specified plasma glucose screening too broadly, it could give credit for non-fasting plasma glucose tests that are not adequate for diagnostic purposes.
Clinical Recommendation Statement | The U.S. Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions (B recommendation) (USPSTF, 2021). Evidence on the optimal screening interval for adults with an initial normal glucose test result is limited. Cohort and modeling studies suggest that screening every 3 years may be a reasonable approach for adults with normal blood glucose levels (USPSTF, 2021). Prediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test. A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour post-load glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes (USPSTF, 2021).
Citation | Centers for Disease Control and Prevention. (2024, July 23). National Diabetes Statistics Report. Retrieved November 15, 2024, from Diabetes website: https://www.cdc.gov/diabetes/php/data-research/
Citation | U.S. Preventive Services Task Force. (2021). Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. JAMA, 326(8), 736–743. https://doi.org/10.1001/jama.2021.12531
Guidance (Usage) | The measure is limited to patients aged 35 to 70 with overweight or obesity because it is recommended that all patients with those risk factors be screened for diabetes at least once every three years. However, this measure is not intended to discourage screening at younger ages, which the USPSTF recommends considering for adults with overweight or obesity and any of the following risk factors: Race/ethnicity with disproportionately high incidence and prevalence of diabetes (American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons) Family history of diabetes History of gestational diabetes History of polycystic ovarian syndrome It is recommended that every patient evaluated by this measure also identify payer, race, ethnicity, and sex. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure CMS1154v1. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
Measure Group (Rate) (ID: Group_1)
Basis | boolean
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: All patients with at least two outpatient clinical encounters or one preventive clinical encounter during the measurement period who have the following risk factors for type 2 diabetes: Most recent BMI ≥25 kg/m2 (BMI ≥23 kg/m2 for Asian patients) during measurement period, AND Age 35-70 at start of measurement period. Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: All patients in the initial population. Logic Definition: Denominator
Denominator Exclusion | ID: DenominatorExclusion_1 Description: Patient's pregnancy overlaps measurement period. Patient with diagnosis of advanced illness or limited life expectancy overlaps measurement period. Patient with diagnosis of diabetes overlaps 2-year look-back period. Patient with diagnosis of prediabetes overlaps 2-year look-back period. Patient with glycemic screening performed during 2-year look-back period. Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: Patients who had a glycemic screening test performed during the measurement period. Logic Definition: Numerator
Supplemental Data Guidance | For every patient evaluated by this measure also identify payer, race, ethnicity and sex.
Supplemental Data Elements
Supplemental Data Element | ID: sde-ethnicity Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Ethnicity Logic Definition: SDE Ethnicity
Supplemental Data Element | ID: sde-payer Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Payer Logic Definition: SDE Payer
Supplemental Data Element | ID: sde-race Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Race Logic Definition: SDE Race
Supplemental Data Element | ID: sde-sex Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Sex Logic Definition: SDE Sex
Measure Logic
Primary Library | https://madie.cms.gov/Library/CMS1154ScreeningPrediabetesFHIR
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      "Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
        and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
            or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
        )
Denominator
    define "Denominator":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      "Has Pregnancy Observation During Measurement Period"
        or exists "Has Pregnancy Diagnosis During Measurement Period"
        or exists "Has Advanced Illness or Limited Life Expectancy"
        or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
        or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
        or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"
Numerator
    define "Numerator":
      exists "Glycemic Laboratory Test Performed During Measurement Period"
Logic Definitions
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Sex":
      case
        when Patient.sex = '248153007' then "Male (finding)"
        when Patient.sex = '248152002' then "Female (finding)"
        else null
      end
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Payer":
      [Coverage: type in "Payer Type"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Ethnicity":
      Patient.ethnicity E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
    value to a CQL DateTime Interval
    @comment: If the start value of the given period is unspecified, the starting
    boundary of the resulting interval will be open (meaning the start of the interval
    is unknown, as opposed to interpreted as the beginning of time).
    */
    define function ToInterval(period FHIR.Period):
        if period is null then
            null
        else
            if period."start" is null then
                Interval(period."start".value, period."end".value]
            else
                Interval[period."start".value, period."end".value]
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
    */
    define function ToCode(coding FHIR.Coding):
        if coding is null then
            null
        else
            System.Code {
              code: coding.code.value,
              system: coding.system.value,
              version: coding.version.value,
              display: coding.display.value
            }
Logic Definition | Library Name: QICoreCommon
    /*
    @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
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Glycemic Laboratory Test Performed During Measurement Period":
      [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
        where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Measurement Period"
          and LabTestPerformed.status in { 'final', 'amended', 'corrected' }
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Numerator":
      exists "Glycemic Laboratory Test Performed During Measurement Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Preventive Care Outpatient Visits During Measurement Period":
      [Encounter: "Preventative Clinical Encounters"] PreventiveCare
        where PreventiveCare.period ends during day of "Measurement Period"
          and PreventiveCare.status = 'finished'
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Office Visit During the Measurement Period":
      [Encounter: "Outpatient Clinical Encounters"] OfficeVisit
        where OfficeVisit.period during day of "Measurement Period"
          and OfficeVisit.status = 'finished'
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Aged 35 to 70 at Start of Measurement Period":
      "AgeInYearsAt"(date from start of "Measurement Period") between 35 and 70
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Patients Aged 35 to 70 with an Office Visit During the Measurement Period":
      ( exists ( "Preventive Care Outpatient Visits During Measurement Period" )
          or Count("Office Visit During the Measurement Period") >= 2
      )
        and "Aged 35 to 70 at Start of Measurement Period" is true
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Most Recent BMI":
      First([USCoreBMIProfile] BMI
          where BMI.status in { 'final', 'amended', 'corrected' }
          sort by start of effective.toInterval() desc
      )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Patient is Asian":
      exists ( SDE."SDE Race".codes C
          where C ~ "Asian"
      )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Patient is not Asian":
      not ( "Patient is Asian" )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian":
      "Most Recent BMI".value >= 25 'kg/m2'
        and "Patient is not Asian"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Most Recent BMI Equal to or Greater Than 23 and Is Asian":
      "Most Recent BMI".value >= 23 'kg/m2'
        and "Patient is Asian"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Initial Population":
      "Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
        and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
            or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
        )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Denominator":
      "Initial Population"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Has Pregnancy Observation During Measurement Period":
      exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
          where PregnantObservation.value in "Pregnancy"
            and PregnantObservation.effective.toInterval ( ) overlaps day of "Measurement Period"
      )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Has Pregnancy Diagnosis During Measurement Period":
      ( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
          union [ConditionEncounterDiagnosis: "Pregnancy"]
      ).verified ( ) ) PregnancyDx
        where PregnancyDx.prevalenceInterval ( ) overlaps day of "Measurement Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Has Advanced Illness or Limited Life Expectancy":
      ( ( ["ConditionProblemsHealthConcerns": "Advanced Illness"]
          union ["ConditionEncounterDiagnosis": "Advanced Illness"]
          union ["ConditionProblemsHealthConcerns": "Limited Life Expectancy"]
          union ["ConditionEncounterDiagnosis": "Limited Life Expectancy"]
      ).verified ( ) ) AdvancedIllness
        where "AdvancedIllness".onset before day of end of "Measurement Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Look Back Period":
      Interval[start of "Measurement Period" - 2 years, start of "Measurement Period" )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Diabetes Diagnosis Overlaps 2 Year Look Back Period":
      ( ( ["ConditionProblemsHealthConcerns": "Diabetes"]
          union [ConditionEncounterDiagnosis: "Diabetes"]
      ).verified ( ) ) PriorDiabetes
        where "PriorDiabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Prediabetes Diagnosis Overlaps 2 Year Look Back Period":
      ( ( ["ConditionProblemsHealthConcerns": "Prediabetes (Borderline Diabetes)"]
          union [ConditionEncounterDiagnosis: "Prediabetes (Borderline Diabetes)"]
      ).verified ( ) ) PriorPrediabetes
        where "PriorPrediabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period":
      exists ( [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
          where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Look Back Period"
            and LabTestPerformed.status in { 'final', 'amended', 'corrected' }
      )
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "Denominator Exclusions":
      "Has Pregnancy Observation During Measurement Period"
        or exists "Has Pregnancy Diagnosis During Measurement Period"
        or exists "Has Advanced Illness or Limited Life Expectancy"
        or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
        or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
        or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS1154ScreeningPrediabetesFHIR
    define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):
      conditions C
        where C.verificationStatus is not null implies ( C.verificationStatus ~ "confirmed"
            or C.verificationStatus ~ "unconfirmed"
            or C.verificationStatus ~ "provisional"
            or C.verificationStatus ~ "differential"
        )
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system CDCREC Resource: urn:oid:2.16.840.1.113883.6.238 Canonical URL: `urn:oid:2.16.840.1.113883.6.238`
Code System | Description: Code system ConditionVerificationStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-ver-status Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Value Set | Description: Value set Glycemic Screening Tests Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5`
Value Set | Description: Value set Preventative Clinical Encounters Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13`
Value Set | Description: Value set Outpatient Clinical Encounters Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24`
Value Set | Description: Value set Payer Type Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591`
Value Set | Description: Value set Pregnancy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378`
Value Set | Description: Value set Advanced Illness Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082`
Value Set | Description: Value set Limited Life Expectancy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259`
Value Set | Description: Value set Diabetes Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001`
Value Set | Description: Value set Prediabetes (Borderline Diabetes) Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419`
Direct Reference Code | Display: Male (finding) Code: 248153007 System: `http://snomed.info/sct`
Direct Reference Code | Display: Female (finding) Code: 248152002 System: `http://snomed.info/sct`
Direct Reference Code | Display: Asian Code: 2028-9 System: `urn:oid:2.16.840.1.113883.6.238`
Direct Reference Code | Display: Confirmed Code: confirmed System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Unconfirmed Code: unconfirmed System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Provisional Code: provisional System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Differential Code: differential System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Dependencies
Dependency | Description: QICore model information Resource: http://hl7.org/fhir/Library/QICore-ModelInfo Canonical URL: `http://hl7.org/fhir/Library/QICore-ModelInfo`
Dependency | Description: Library SDE Resource: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 Canonical URL: `https://madie.cms.gov/Library/SupplementalDataElements|5.1.000`
Dependency | Description: Library FHIRHelpers Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 Canonical URL: `https://madie.cms.gov/Library/FHIRHelpers|4.4.000`
Dependency | Description: Library QICoreCommon Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000 Canonical URL: `https://madie.cms.gov/Library/QICoreCommon|4.0.000`
Data Requirements
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: extension, url, birthDate, birthDate.value
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab Must Support Elements: code, effective, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi Must Support Elements: status, status.value, value
Data Requirement | Type: Coverage Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus Must Support Elements: value, effective, effective.value
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419
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