Metadata
Title | Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes CareFHIR
Version | 1.0.000
Short Name | CMS142FHIR
GUID (Version Independent) | urn:uuid:0f55e61f-dc17-4fe4-a604-7f030260618f
GUID (Version Specific) | urn:uuid:37dd2397-d9cd-401d-b343-28d77fd2f923
CMS Identifier | 142FHIR
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | American Academy of Ophthalmology
Developer | American Academy of Ophthalmology
Developer | American Medical Association (AMA)
Description | Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once during the measurement period
Copyright | Copyright 2025 American Academy of Ophthalmology. All Rights Reserved.
Disclaimer | The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measure require a license agreement between the user and the American Academy of Ophthalmology (Academy). Neither the Academy, its members, the American Medical Association (AMA), nor the former AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), nor PCPI, nor their members shall be responsible for any use of the Measure. The PCPI’s and AMA’s significant past efforts and contributions to the development and updating of the Measures are acknowledged. The National Committee for Quality Assurance's significant past efforts and contributions to the development and updating of the Measure is acknowledged. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Limited proprietary coding is contained in the Measure specifications for convenience. A license agreement must be entered prior to a third party’s use of Current Procedural Terminology (CPT[R]) or other proprietary code set contained in the Measures. Any other use of CPT or other coding by the third party is strictly prohibited. The Academy, the AMA, and former members of the PCPI disclaim all liability for use or accuracy of any CPT or other coding contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved. Due to technical limitations, registered trademarks are indicated by (R) or [R].
Rationale | Diabetic retinopathy is a prevalent complication of diabetes, estimated to affect 28.5% of diabetic patients in the US (Zhang et al., 2010). Diabetic retinopathy is a key indicator of systemic complications of diabetes (Zhang et al., 2010). Coordination of care between the eye care specialist and the physician managing a patient’s ongoing diabetes care is essential in stemming the progression of vision loss. Communication from the eye care specialist to a primary care physician facilitates the exchange of information about the severity and progression of a patient’s diabetic retinopathy, adherence to recommended ocular care, need for follow-up visits, and treatment plans (Storey et al., 2016). Data from the Diabetes Control and Complications Trial showed that diabetic treatment and maintenance of glucose control delays the onset and slows the progression of diabetic retinopathy (Aiello & DCCT/EDIC Research Group, 2014).
Clinical Recommendation Statement | The ophthalmologist should refer patients with diabetes to a primary care physician or endocrinologist for appropriate management of their systemic condition and should communicate examination results to the physician managing the patient’s ongoing diabetes care (Lim et al., 2025). A goal is to achieve optimal control of blood glucose, blood pressure, and other risk factors through close communication with the patient’s primary care physician on the status of the DR and the need for optimal metabolic control (Lim et al,, 2025). Establishing a close partnership between the ophthalmologist and the primary care physician is an important step to ensure optimal patient care. Furthermore, it is important to help educate patients with diabetes as well as their primary care physician about the ophthalmologic implications of controlling blood glucose (as monitored by HbA1c) to as near to normal as is safely possible (Lim et al., 2025).
Citation | Aiello, L. P., & DCCT/EDIC Research Group (2014). Diabetic retinopathy and other ocular findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes care, 37(1), 17–23. doi:10.2337/dc13-2251
Citation | Lim, J.I., Kim, S.J., Bailey, S.T., Kovach, J.L., Vemulakonda, G.A., Ying, G., Flaxel, C.J. and the American Academy of Ophthalmology Preferred Practice Pattern Retina/Vitreous Committee (2025). Diabetic Retinopathy Preferred Practice Pattern. Ophthalmology. 2025 in press. doi: 10.1016/j.ophtha.2024.12.020
Citation | Storey, P. P., Murchison, A. P., Pizzi, L. T., Hark, L. A., Dai, Y., Leiby, B. E., & Haller, J. A. Impact of physician communication on diabetic eye examination adherence: Results from a Retrospective Cohort Analysis. Retina. 2016 Jan;36(1),20-7. doi:10.1097/IAE.0000000000000652
Citation | Zhang, X., Saaddine, J. B., Chou, C. F., Cotch, M. F., Cheng, Y. J., Geiss, L. S., … Klein, R. (2010). Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA, 304(6), 649–656. doi:10.1001/jama.2010.1111
Definition | Communication: May include documentation in the medical record indicating that the findings of the dilated macular or fundus exam were communicated (e.g., verbally, by letter) with the clinician managing the patient's diabetic care OR a copy of a letter in the medical record to the clinician managing the patient's diabetic care outlining the findings of the dilated macular or fundus exam
Definition | Findings: Includes level of severity of retinopathy (e.g., mild nonproliferative, moderate nonproliferative, severe nonproliferative, very severe nonproliferative, proliferative) AND the presence or absence of macular edema
Guidance (Usage) | The measure, as written, does not specifically require documentation of laterality. Coding limitations in particular clinical terminologies do not currently allow for that level of specificity (ICD-10-CM includes laterality, but SNOMED-CT does not uniformly include this distinction). Therefore, at this time, it is not a requirement of this measure to indicate laterality of the diagnoses, findings or procedures. Available coding to capture the data elements specified in this measure has been provided. It is assumed that the eligible clinician will record laterality in the patient medical record, as quality care and clinical documentation should include laterality. The communication of results, including the level of severity of diabetic retinopathy and presence or absence of macular edema to the primary care physician providing ongoing care of a patient's diabetes should be completed soon after the dilated exam is performed. Eligible clinicians reporting on this measure should note that all data for the measurement period is to be submitted by the deadline established by CMS. Therefore, eligible clinicians who see patients towards the end of the measurement period (i.e., December in particular), should communicate the results of the dilated macular exam as soon as possible in order for those patients to be counted in the measure numerator. Communicating the results as soon as possible after the date of the exam will ensure the data are included in the submission to CMS. This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. This FHIR-based measure has been derived from the QDM-based measure CMS142v14. 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 aged 18 years and older with a diagnosis of diabetic retinopathy during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Equals Initial Population who had a dilated macular or fundus exam performed during the measurement period Logic Definition: Denominator
Numerator | ID: Numerator_1 Description: Patients with documentation, at least once within the measurement period, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient's diabetic care Logic Definition: Numerator
Denominator Exception | ID: DenominatorException_1 Description: Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes. Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes. Logic Definition: Denominator Exceptions
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/CMS142FHIRCommWithDrManagingDiab
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      AgeInYearsAt(date from start of "Measurement Period") >= 18
        and exists "Diabetic Retinopathy Encounter"
Denominator
    define "Denominator":
      "Initial Population"
        and exists "Macular Exam Performed"
Numerator
    define "Numerator":
      exists "Level of Severity of Retinopathy Findings Communicated"
        and ( exists "Macular Edema Absence Communicated"
            or exists "Macular Edema Presence Communicated"
        )
Denominator Exception
    define "Denominator Exceptions":
      exists "Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy"
        or exists "Medical or Patient Reason for Not Communicating Absence of Macular Edema"
        or exists "Medical or Patient Reason for Not Communicating Presence of Macular Edema"
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 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: SupplementalDataElements
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Qualifying Encounter During Day of Measurement Period":
      ( ["Encounter": "Office Visit"]
        union ["Encounter": "Ophthalmological Services"]
        union ["Encounter": "Outpatient Consultation"]
        union ["Encounter": "Care Services in Long-Term Residential Facility"]
        union ["Encounter": "Nursing Facility Visit"] ) QualifyingEncounter
        where QualifyingEncounter.period during day of "Measurement Period"
          and QualifyingEncounter.status = 'finished'
          and QualifyingEncounter.class !~ "virtual"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Diabetic Retinopathy Encounter":
      "Qualifying Encounter During Day of Measurement Period" ValidQualifyingEncounter
        with ( ["ConditionProblemsHealthConcerns": "Diabetic Retinopathy"]
          union ["ConditionEncounterDiagnosis": "Diabetic Retinopathy"] ) DiabeticRetinopathy
          such that DiabeticRetinopathy.prevalenceInterval ( ) overlaps day of ValidQualifyingEncounter.period
            and DiabeticRetinopathy.isVerified ( )
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Level of Severity of Retinopathy Findings Communicated":
      ["Communication": category in "Level of Severity of Retinopathy Findings"] LevelOfSeverityCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that LevelOfSeverityCommunicated.sent after start of EncounterDiabeticRetinopathy.period
            and LevelOfSeverityCommunicated.sent during day of "Measurement Period"
        where LevelOfSeverityCommunicated.status = 'completed'
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Macular Edema Absence Communicated":
      ["Communication": category in "Macular Edema Findings Absent"] MacularEdemaAbsentCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that MacularEdemaAbsentCommunicated.sent after start of EncounterDiabeticRetinopathy.period
            and MacularEdemaAbsentCommunicated.sent during day of "Measurement Period"
        where MacularEdemaAbsentCommunicated.status = 'completed'
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Macular Edema Presence Communicated":
      ["Communication": category in "Macular Edema Findings Present"] MacularEdemaPresentCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that MacularEdemaPresentCommunicated.sent after start of EncounterDiabeticRetinopathy.period
            and MacularEdemaPresentCommunicated.sent during "Measurement Period"
        where MacularEdemaPresentCommunicated.status = 'completed'
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Numerator":
      exists "Level of Severity of Retinopathy Findings Communicated"
        and ( exists "Macular Edema Absence Communicated"
            or exists "Macular Edema Presence Communicated"
        )
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Initial Population":
      AgeInYearsAt(date from start of "Measurement Period") >= 18
        and exists "Diabetic Retinopathy Encounter"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Macular Exam Performed":
      ["ObservationClinicalResult": "Macular Exam"] MacularExam
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that MacularExam.effective.toInterval ( ) during EncounterDiabeticRetinopathy.period
        where MacularExam.value is not null
          and MacularExam.status in { 'final', 'amended', 'corrected' }
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Denominator":
      "Initial Population"
        and exists "Macular Exam Performed"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy":
      [CommunicationNotDone: category in "Level of Severity of Retinopathy Findings"] LevelOfSeverityNotCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that LevelOfSeverityNotCommunicated.recorded during day of EncounterDiabeticRetinopathy.period
        where ( LevelOfSeverityNotCommunicated.statusReason in "Medical Reason"
            or LevelOfSeverityNotCommunicated.statusReason in "Patient Reason"
        )
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    /* Note:
    below definition workaround for
    https://oncprojectracking.healthit.gov/support/browse/CQLIT-371. Using value set workaround has been applied for now
    but when QI Core STU 5 gets in the tool, it may be reverted back to a DRC */

    define "Medical or Patient Reason for Not Communicating Absence of Macular Edema":
      [CommunicationNotDone: category in "Macular Edema Findings Absent"] MacularEdemaAbsentNotCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that MacularEdemaAbsentNotCommunicated.recorded during day of EncounterDiabeticRetinopathy.period
        where ( MacularEdemaAbsentNotCommunicated.statusReason in "Medical Reason"
            or MacularEdemaAbsentNotCommunicated.statusReason in "Patient Reason"
        )
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Medical or Patient Reason for Not Communicating Presence of Macular Edema":
      [CommunicationNotDone: category in "Macular Edema Findings Present"] MacularEdemaPresentNotCommunicated
        with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
          such that MacularEdemaPresentNotCommunicated.recorded during day of EncounterDiabeticRetinopathy.period
        where ( MacularEdemaPresentNotCommunicated.statusReason in "Medical Reason"
            or MacularEdemaPresentNotCommunicated.statusReason in "Patient Reason"
        )
Logic Definition | Library Name: CMS142FHIRCommWithDrManagingDiab
    define "Denominator Exceptions":
      exists "Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy"
        or exists "Medical or Patient Reason for Not Communicating Absence of Macular Edema"
        or exists "Medical or Patient Reason for Not Communicating Presence of Macular Edema"
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
            }
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system ActCode Resource: http://terminology.hl7.org/CodeSystem/v3-ActCode Canonical URL: `http://terminology.hl7.org/CodeSystem/v3-ActCode`
Value Set | Description: Value set Level of Severity of Retinopathy Findings Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283`
Value Set | Description: Value set Office Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001`
Value Set | Description: Value set Ophthalmological Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285`
Value Set | Description: Value set Outpatient Consultation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008`
Value Set | Description: Value set Care Services in Long-Term Residential Facility Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014`
Value Set | Description: Value set Nursing Facility Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012`
Value Set | Description: Value set Diabetic Retinopathy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327`
Value Set | Description: Value set Macular Edema Findings Absent Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391`
Value Set | Description: Value set Macular Edema Findings Present Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320`
Value Set | Description: Value set Macular Exam Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1251 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1251`
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 Medical Reason Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007`
Value Set | Description: Value set Patient Reason Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008`
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: virtual Code: VR System: `http://terminology.hl7.org/CodeSystem/v3-ActCode`
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
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, class Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, class Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, class Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, class Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, class Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012
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/2.16.840.1.113883.3.526.3.327
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/2.16.840.1.113883.3.526.3.327
Data Requirement | Type: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication Must Support Elements: category, sent, sent.value, status, status.value Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283
Data Requirement | Type: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication Must Support Elements: category, sent, sent.value, status, status.value Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391
Data Requirement | Type: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication Must Support Elements: category, sent, sent.value, status, status.value Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-clinical-result Must Support Elements: code, effective, value, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1251
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: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Must Support Elements: category, extension, statusReason Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283
Data Requirement | Type: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Must Support Elements: category, extension, statusReason Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391
Data Requirement | Type: Communication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Must Support Elements: category, extension, statusReason Code Filter(s): Path: category ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320
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