Metadata
Title | Preventive Care and Screening: Tobacco Use: Screening and Cessation InterventionFHIR
Version | 1.0.000
Short Name | CMS138FHIR
GUID (Version Independent) | urn:uuid:d77f147d-5ccc-4ff3-8739-3aa5dc0aea12
GUID (Version Specific) | urn:uuid:04caa1ba-aa09-497c-86b9-d40b493fd443
CMS Identifier | 138FHIR
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | National Committee for Quality Assurance
Developer | American Medical Association (AMA)
Developer | National Committee for Quality Assurance
Description | Percentage of patients aged 12 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user. Three rates are reported: a. Percentage of patients aged 12 years and older who were screened for tobacco use one or more times during the measurement period b. Percentage of patients aged 12 years and older who were identified as a tobacco user during the measurement period who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period c. Percentage of patients aged 12 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user
Copyright | This Physician Performance Measure (Measure) and related data specifications are owned by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. 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. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. The Physician Consortium for Performance Improvement’s (PCPI) and American Medical Association’s (AMA) significant past efforts and contributions to the development and updating of the measure are acknowledged. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. 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 2025. 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. Some measure specifications contain coding from LOINC(R) (https://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 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.
Disclaimer | The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Rationale | This measure is intended to promote adult tobacco screening and tobacco cessation interventions for those who use tobacco products. There is good evidence that tobacco screening and brief cessation intervention (including counseling and/or pharmacotherapy) is successful in helping tobacco users quit. Tobacco users who are able to stop using tobacco lower their risk for heart disease, lung disease, and stroke.
Clinical Recommendation Statement | The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and U.S. Food and Drug Administration (FDA)-approved pharmacotherapy for cessation to nonpregnant adults who use tobacco (Grade A Recommendation) (U.S. Preventive Services Task Force, 2021). The USPSTF recommends that clinicians ask all pregnant persons about tobacco use, advise them to stop using tobacco, and provide behavioral interventions for cessation to pregnant persons who use tobacco (Grade A Recommendation) (U.S. Preventive Services Task Force, 2021). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of pharmacotherapy interventions for tobacco cessation in pregnant women (Grade I Statement) (U.S. Preventive Services Task Force, 2021). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of electronic cigarettes (e-cigarettes) for tobacco cessation in adults, including pregnant persons. The USPSTF recommends that clinicians direct patients who use tobacco to other tobacco cessation interventions with proven effectiveness and established safety (Grade I Statement) (U.S. Preventive Services Task Force, 2021). The USPSTF recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents (Grade B Statement) (U.S. Preventive Services Task Force, 2020). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care--feasible interventions for the cessation of tobacco use among school-aged children and adolescents (Grade I Statement) (U.S. Preventive Services Task Force, 2020). All patients should be asked if they use tobacco and should have their tobacco use status documented on a regular basis. Evidence has shown that clinic screening systems, such as expanding the vital signs to include tobacco use status or the use of other reminder systems such as chart stickers or computer prompts, significantly increase rates of clinician intervention. (Strength of Evidence = A) (U.S. Department of Health and Human Services. Public Health Service, 2008). All physicians should strongly advise every patient who smokes to quit because evidence shows that physician advice to quit smoking increases abstinence rates. (Strength of Evidence = A) (U.S. Department of Health and Human Services. Public Health Service, 2008). Minimal interventions lasting less than 3 minutes increase overall tobacco abstinence rates. Every tobacco user should be offered at least a minimal intervention, whether or not he or she is referred to an intensive intervention. (Strength of Evidence = A) (U.S. Department of Health and Human Services. Public Health Service, 2008). The combination of counseling and medication is more effective for smoking cessation than either medication or counseling alone. Therefore, whenever feasible and appropriate, both counseling and medication should be provided to patients trying to quit smoking. (Strength of Evidence = A) (U.S. Department of Health and Human Services. Public Health Service, 2008).
Citation | US Department of Health and Human Services. (2008). 6, Evidence and Recommendations. Treating Tobacco Use and Dependence: 2008 Update. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK63943/
Citation | US Preventive Services Task Force. (2020). Primary Care Interventions for Prevention and Cessation of Tobacco Use in Children and Adolescents. US Preventive Services Task Force Recommendation Statement. JAMA, 2020;323(16):1590-1598. doi:10.1001/jama.2020.4679
Citation | US Preventive Services Task Force. (2021). Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons. US Preventive Services Task Force Recommendation Statement. JAMA, 325(3), 265-279. doi:10.1001/jama.2020.25019
Definition | Tobacco Cessation Intervention: Includes brief counseling (3 minutes or less), and/or pharmacotherapy. Note: Concepts aligned with brief counseling (e.g., minimal and intensive advice/counseling interventions conducted both in person and over the phone) are included in the value set for the numerator. Other concepts such as written self-help materials (e.g., brochures, pamphlets) and complementary/alternative therapies are not included in the value set and do not qualify for the numerator. Counseling also may be of longer duration or be performed more frequently, as evidence shows that higher-intensity interventions are associated with higher tobacco cessation rates (U.S. Preventive Services Task Force, 2021).
Definition | Tobacco Use: Use of any tobacco product. The 2021 USPSTF recommendation references the US Food and Drug Administration definition of tobacco which includes "any product made or derived from tobacco intended for human consumption (except products that meet the definition of drugs), including, but not limited to, cigarettes, cigars (including cigarillos and little cigars), dissolvables, hookah tobacco, nicotine gels, pipe tobacco, roll-your-own tobacco, smokeless tobacco products (including dip, snuff, snus, and chewing tobacco), vapes, electronic cigarettes (e-cigarettes), hookah pens, and other electronic nicotine delivery systems." The 2021 USPSTF recommendation describes smoking as generally referring to "the inhaling and exhaling of smoke produced by combustible tobacco products such as cigarettes, cigars, and pipes." The 2021 USPSTF recommendation describes vaping as "the inhaling and exhaling of aerosols produced by e-cigarettes." In addition, it states, "vaping products (i.e., e-cigarettes) usually contain nicotine, which is the addictive ingredient in tobacco. Substances other than tobacco can also be used to smoke or vape. While the 2015 USPSTF recommendation statement used the term 'electronic nicotine delivery systems' or 'ENDS,' the USPSTF recognizes that the field has shifted to using the term 'e-cigarettes' (or 'e-cigs') and uses the term e-cigarettes in the current recommendation statement. e-Cigarettes can come in many shapes and sizes, but generally they heat a liquid that contains nicotine (the addictive drug in tobacco) to produce an aerosol (or 'vapor') that is inhaled ('vaped') by users."
Guidance (Usage) | The requirement of two or more visits is to establish that the eligible clinician has an existing relationship with the patient for certain types of encounters. To satisfy the intent of this measure, a patient must have at least one tobacco use screening during the measurement period. If a patient has multiple tobacco use screenings during the measurement period, only the most recent screening, which has a documented status of tobacco user or tobacco non-user, will be used to satisfy the measure requirements. If a patient uses any type of tobacco (i.e., smokes or uses smokeless tobacco), the expectation is that they should receive tobacco cessation intervention: either counseling and/or pharmacotherapy. As noted above in the 2021 USPSTF recommendation statement, the current evidence is insufficient to recommend electronic cigarettes (e-cigarettes) for tobacco cessation. However, as noted above in the Definition section, the 2021 USPSTF recommendation also references the US Food and Drug Administration definition of tobacco, which includes e-cigarettes, hookah pens and other electronic nicotine delivery systems. Therefore, the measure does consider the use of e-cigarettes and other electronic nicotine delivery systems to be tobacco use. If a patient's tobacco use status is unknown, the patient does not meet the screening requirement and does not meet the numerator for populations 1 or 3. Instances where tobacco use status of "unknown" include: 1) the patient was not screened; or 2) the patient was screened and the patient (or caregiver) was unable to provide a definitive answer. In order to promote a team-based approach to patient care, the tobacco cessation intervention can be performed by another healthcare provider; therefore, the tobacco use screening and tobacco cessation intervention do not need to be performed by the same provider or clinician. This measure contains three reporting rates which aim to identify patients who were screened for tobacco use (rate/population 1), patients who were identified as tobacco users and who received a tobacco cessation intervention (rate/population 2), and a comprehensive look at the overall performance on tobacco screening and cessation intervention (rate/population 3). By separating this measure into various reporting rates, the eligible clinician will be able to better ascertain where gaps in performance exist, and identify opportunities for improvement. The overall rate (rate/population 3) can be utilized to compare performance to published versions of this measure prior to the 2018 performance year, when the measure had a single performance rate. For accountability reporting in the CMS MIPS program, the rate for population 2 is used for performance. The denominator of population criteria 2 is a subset of the resulting numerator for population criteria 1, as population criteria 2 is limited to assessing if patients identified as tobacco users received an appropriate tobacco cessation intervention. For all patients, population criteria 1 and 3 are applicable, but population criteria 2 will only be applicable for those patients who are identified as tobacco users. Therefore, data for every patient that meets the initial population criteria will only be submitted for population 1 and 3, whereas data submitted for population 2 will be for a subset of patients who meet the initial population criteria, as the denominator has been further limited to those who were identified as tobacco users. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS138v14. 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']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Population 1: Equals Initial Population. Logic Definition: Denominator 1
Denominator Exclusion | ID: DenominatorExclusion_1 Description: Exclude patients who are in hospice care for any part of the measurement period Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: Population 1: Patients who were screened for tobacco use at least once during the measurement period. Logic Definition: Numerator 1
Measure Group (Rate) (ID: Group_2)
Basis | boolean
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_2 Description: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_2 Description: Population 2: Equals Initial Population who were screened for tobacco use during the measurement period and identified as a tobacco user. Logic Definition: Denominator 2
Denominator Exclusion | ID: DenominatorExclusion_2 Description: Exclude patients who are in hospice care for any part of the measurement period Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_2 Description: Population 2: Patients who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period. Logic Definition: Numerator 2
Measure Group (Rate) (ID: Group_3)
Basis | boolean
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_3 Description: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_3 Description: Population 3: Equals Initial Population. Logic Definition: Denominator 3
Denominator Exclusion | ID: DenominatorExclusion_3 Description: Exclude patients who are in hospice care for any part of the measurement period Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_3 Description: Population 3: Patients who were screened for tobacco use at least once during the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user. Logic Definition: Numerator 3
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/CMS138FHIRTobaccoScrnCessation
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") >= 12
        and ( Count("Qualifying Visit During Measurement Period") >= 2
            or exists "Preventive Visit During Measurement Period"
        )
Denominator
    define "Denominator 1":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
Numerator
    define "Numerator 1":
      "Most Recent Tobacco Use Screening Indicates Tobacco Non User" is not null
        or "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
Measure Group (Rate) (ID: Group_2)
Initial Population
    define "Initial Population":
      AgeInYearsAt(date from start of "Measurement Period") >= 12
        and ( Count("Qualifying Visit During Measurement Period") >= 2
            or exists "Preventive Visit During Measurement Period"
        )
Denominator
    define "Denominator 2":
      "Initial Population"
        and "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
Denominator Exclusion
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
Numerator
    define "Numerator 2":
      exists "Tobacco Cessation Counseling Given"
        or exists "Tobacco Cessation Pharmacotherapy Ordered"
        or exists "Active Pharmacotherapy for Tobacco Cessation"
Measure Group (Rate) (ID: Group_3)
Initial Population
    define "Initial Population":
      AgeInYearsAt(date from start of "Measurement Period") >= 12
        and ( Count("Qualifying Visit During Measurement Period") >= 2
            or exists "Preventive Visit During Measurement Period"
        )
Denominator
    define "Denominator 3":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
Numerator
    define "Numerator 3":
      "Most Recent Tobacco Use Screening Indicates Tobacco Non User" is not null
        or ( "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
            and ( exists "Tobacco Cessation Counseling Given"
                or exists "Tobacco Cessation Pharmacotherapy Ordered"
                or exists "Active Pharmacotherapy for Tobacco Cessation"
            )
        )
Logic Definitions
Logic Definition | Library Name: Hospice
    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 ends during day of "Measurement Period"
      )
        or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
            where HospiceEncounter.period overlaps day of "Measurement Period"
        )
        or exists ((([ObservationScreeningAssessment: "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 during day of "Measurement Period"
        )
        or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
            where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
        )
        or exists ((([ConditionProblemsHealthConcerns: "Hospice Diagnosis"]
            union [ConditionEncounterDiagnosis: "Hospice Diagnosis"]).verified()) HospiceCareDiagnosis
            where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
        )
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: CMS138FHIRTobaccoScrnCessation
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Qualifying Visit During Measurement Period":
      ( ( ( [Encounter] E
            where exists ( ( E.type ) T
                where T ~ "Health behavior intervention, individual, face-to-face; initial 30 minutes"
            )
        )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ "Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)"
              )
          )
          union [Encounter: "Home Healthcare Services"]
          union [Encounter: "Occupational Therapy Evaluation"]
          union [Encounter: "Office Visit"]
          union [Encounter: "Ophthalmological Services"]
          union [Encounter: "Physical Therapy Evaluation"]
          union [Encounter: "Psych Visit Diagnostic Evaluation"]
          union [Encounter: "Psych Visit Psychotherapy"]
          union [Encounter: "Psychoanalysis"]
          union [Encounter: "Speech and Hearing Evaluation"]
          union [Encounter: "Telephone Visits"]
          union [Encounter: "Virtual Encounter"]
      ).isEncounterPerformed ( ) ) OfficeBasedEncounter
        where OfficeBasedEncounter.period during day of "Measurement Period"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Preventive Visit During Measurement Period":
      ( ( [Encounter: "Annual Wellness Visit"]
          union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]
          union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]
          union [Encounter: "Preventive Care, Established Office Visit, 0 to 17"]
          union [Encounter: "Preventive Care Services, Initial Office Visit, 0 to 17"]
          union [Encounter: "Preventive Care Services Group Counseling"]
          union [Encounter: "Preventive Care Services Individual Counseling"]
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ "Unlisted preventive medicine service"
              )
          )
          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: "Nutrition Services"]
      ).isEncounterPerformed ( ) ) PreventiveEncounter
        where PreventiveEncounter.period during day of "Measurement Period"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Initial Population":
      AgeInYearsAt(date from start of "Measurement Period") >= 12
        and ( Count("Qualifying Visit During Measurement Period") >= 2
            or exists "Preventive Visit During Measurement Period"
        )
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Denominator 3":
      "Initial Population"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Most Recent Tobacco Use Screening Indicates Tobacco Non User":
      ( Last((([USCoreSmokingStatusProfile]).isObservationSmokingStatus()) TobaccoUseScreening
          where TobaccoUseScreening.effective.toInterval() during day of "Measurement Period"
          sort by start of effective.toInterval()
      ) ) MostRecentTobaccoUseScreening
        where MostRecentTobaccoUseScreening.value as Concept in "Tobacco Non User"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Most Recent Tobacco Use Screening Indicates Tobacco User":
      ( Last((([USCoreSmokingStatusProfile]).isObservationSmokingStatus()) TobaccoUseScreening
          where TobaccoUseScreening.effective.toInterval() during day of "Measurement Period"
          sort by start of effective.toInterval()
      ) ) MostRecentTobaccoUseScreening
        where MostRecentTobaccoUseScreening.value as Concept in "Tobacco User"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Tobacco Cessation Counseling Given":
      ( ( ( [Procedure: "Tobacco Use Cessation Counseling"] ).isInterventionPerformed ( ) ) TobaccoCessationCounseling
          where TobaccoCessationCounseling.performed.toInterval ( ) during day of Interval[start of "Measurement Period" - 6 months, end of "Measurement Period"]
      )
        union ( ( ( [ConditionProblemsHealthConcerns: "Tobacco abuse counseling"]
              union [ConditionEncounterDiagnosis: "Tobacco abuse counseling"]
          ).verified ( ) ) TobaccoCounseling
            where TobaccoCounseling.prevalenceInterval ( ) starts during day of Interval[start of "Measurement Period" - 6 months, end of "Measurement Period"]
        )
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Tobacco Cessation Pharmacotherapy Ordered":
      ( ( [MedicationRequest: "Tobacco Use Cessation Pharmacotherapy"] ).isMedicationOrder ( ) ) CessationPharmacotherapyOrdered
        where CessationPharmacotherapyOrdered.authoredOn during day of Interval[start of "Measurement Period" - 6 months, end of "Measurement Period"]
          and not exists ( [TaskRejected] TaskReject
              where TaskReject.focus.references ( CessationPharmacotherapyOrdered )
                and TaskReject.code ~ "fulfill"
          )
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Active Pharmacotherapy for Tobacco Cessation":
      ( ( [MedicationRequest: "Tobacco Use Cessation Pharmacotherapy"] ).isMedicationActive ( ) ) TakingCessationPharmacotherapy
        where TakingCessationPharmacotherapy.medicationRequestPeriod ( ) during day of Interval[start of "Measurement Period" - 6 months, end of "Measurement Period"]
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Numerator 3":
      "Most Recent Tobacco Use Screening Indicates Tobacco Non User" is not null
        or ( "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
            and ( exists "Tobacco Cessation Counseling Given"
                or exists "Tobacco Cessation Pharmacotherapy Ordered"
                or exists "Active Pharmacotherapy for Tobacco Cessation"
            )
        )
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Denominator 2":
      "Initial Population"
        and "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Numerator 1":
      "Most Recent Tobacco Use Screening Indicates Tobacco Non User" is not null
        or "Most Recent Tobacco Use Screening Indicates Tobacco User" is not null
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Numerator 2":
      exists "Tobacco Cessation Counseling Given"
        or exists "Tobacco Cessation Pharmacotherapy Ordered"
        or exists "Active Pharmacotherapy for Tobacco Cessation"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS138FHIRTobaccoScrnCessation
    define "Denominator 1":
      "Initial Population"
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @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
            }
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: 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: 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: QICoreCommon
    /*
    @description: Returns true if the given reference is to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference Reference, resource Resource):
      resource.id = Last(Split(reference.reference, '/'))
Logic Definition | Library Name: CumulativeMedicationDuration
    define fluent function medicationRequestPeriod(Request "MedicationRequest"):
      Request R
        let
          dosage: singleton from R.dosageInstruction,
          doseAndRate: singleton from dosage.doseAndRate,
          timing: dosage.timing,
          frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
          period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
          doseRange: doseAndRate.dose,
          doseQuantity: doseAndRate.dose,
          dose: Coalesce(end of doseRange, doseQuantity),
          dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
          boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
          daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
          quantity: R.dispenseRequest.quantity,
          refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
          startDate:
            Coalesce(
              date from start of boundsPeriod,
              date from R.authoredOn,
              date from start of R.dispenseRequest.validityPeriod
            ),
          totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
        return
          if startDate is not null and totalDaysSupplied is not null then
            Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
          else if startDate is not null and boundsPeriod."high" is not null then
            Interval[startDate, date from end of boundsPeriod]
          else
            null
Logic Definition | Library Name: CumulativeMedicationDuration
    /**********************************************************************/
    /* Functions in this region are copied from opioid-mme-r4             */
    /**********************************************************************/

    define function Quantity(value Decimal, unit String):
      if value is not null then
        System.Quantity { value: value, unit: unit }
      else
        null
Logic Definition | Library Name: CumulativeMedicationDuration
    /*
     Goal is to get to number of days
     Two broad approaches to the calculation:
      1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
      2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
    This topic covers several use cases and illustrates how to calculate Cumulative
    Medication Duration for each type of medication resource using the supply and
    frequency approach.
    */

    /*
      For the first approach, we need to get from frequency to a frequency/day
      So we define ToDaily
    */

    /*
      Calculates daily frequency given frequency within a period
    */
    define function ToDaily(frequency System.Integer, period System.Quantity):
      case period.unit
        when 'h' then frequency * (24.0 / period.value)
        when 'min' then frequency * (24.0 / period.value) * 60
        when 's' then frequency * (24.0 / period.value) * 60 * 60
        when 'd' then frequency * (24.0 / period.value) / 24
        when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
        when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hour' then frequency * (24.0 / period.value)
        when 'minute' then frequency * (24.0 / period.value) * 60
        when 'second' then frequency * (24.0 / period.value) * 60 * 60
        when 'day' then frequency * (24.0 / period.value) / 24
        when 'week' then frequency * (24.0 / period.value) / (24 * 7)
        when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hours' then frequency * (24.0 / period.value)
        when 'minutes' then frequency * (24.0 / period.value) * 60
        when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
        when 'days' then frequency * (24.0 / period.value) / 24
        when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
        when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
      end
Logic Definition | Library Name: Status
    //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 = 'finished'
Logic Definition | Library Name: Status
    //Observation Smoking Status
    define fluent function isObservationSmokingStatus(Obs List<USCoreSmokingStatusProfile>):
      Obs O
        where O.status = 'final'
Logic Definition | Library Name: Status
    //Intervention, Performed
    define fluent function isInterventionPerformed(Proc List<Procedure>):
      Proc P
        where P.status ~ 'completed'
Logic Definition | Library Name: Status
    //This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.

    //Condition
    //Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
    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"
          )
Logic Definition | Library Name: Status
    //Medication, Order
    define fluent function isMedicationOrder(MedicationRequest List<MedicationRequest>):
      MedicationRequest M
        where M.status in { 'active', 'completed' }
        and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Status
    //Medication, Active
    define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>):
      MedicationRequest M
        where M.status = 'active'
          and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Status
    //Assessment, Performed
    define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }
Logic Definition | Library Name: Status
    //Intervention, Order
    define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
      ServiceRequest S
        where S.status in { 'active', 'completed' }
          and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system CPT Resource: http://www.ama-assn.org/go/cpt Canonical URL: `http://www.ama-assn.org/go/cpt`
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`
Code System | Description: Code system ICD10CM Resource: http://hl7.org/fhir/sid/icd-10-cm Canonical URL: `http://hl7.org/fhir/sid/icd-10-cm`
Code System | Description: Code system TaskCode Resource: http://hl7.org/fhir/CodeSystem/task-code Canonical URL: `http://hl7.org/fhir/CodeSystem/task-code`
Code System | Description: Code system LOINC Resource: http://loinc.org Canonical URL: `http://loinc.org`
Value Set | Description: Value set Home Healthcare Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016`
Value Set | Description: Value set Occupational Therapy Evaluation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1011 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1011`
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 Physical Therapy Evaluation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022`
Value Set | Description: Value set Psych Visit Diagnostic Evaluation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492`
Value Set | Description: Value set Psych Visit Psychotherapy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1496 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1496`
Value Set | Description: Value set Psychoanalysis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1141 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1141`
Value Set | Description: Value set Speech and Hearing Evaluation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1530 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1530`
Value Set | Description: Value set Telephone Visits Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080`
Value Set | Description: Value set Virtual Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089`
Value Set | Description: Value set Annual Wellness Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240`
Value Set | Description: Value set Preventive Care Services Established Office Visit, 18 and Up Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025`
Value Set | Description: Value set Preventive Care Services Initial Office Visit, 18 and Up Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023`
Value Set | Description: Value set Preventive Care, Established Office Visit, 0 to 17 Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024`
Value Set | Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17 Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022`
Value Set | Description: Value set Preventive Care Services Group Counseling Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027`
Value Set | Description: Value set Preventive Care Services Individual Counseling Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026`
Value Set | Description: Value set Nutrition Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006`
Value Set | Description: Value set Tobacco Non User Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1189 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1189`
Value Set | Description: Value set Tobacco User Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1170 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1170`
Value Set | Description: Value set Tobacco Use Cessation Counseling Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.509 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.509`
Value Set | Description: Value set Tobacco Use Cessation Pharmacotherapy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1190 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1190`
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 Encounter Inpatient Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307`
Value Set | Description: Value set Hospice Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003`
Value Set | Description: Value set Hospice Care Ambulatory Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584`
Value Set | Description: Value set Hospice Diagnosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165`
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: Health behavior intervention, individual, face-to-face; initial 30 minutes Code: 96158 System: `http://www.ama-assn.org/go/cpt`
Direct Reference Code | Display: Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making) Code: 96156 System: `http://www.ama-assn.org/go/cpt`
Direct Reference Code | Display: Unlisted preventive medicine service Code: 99429 System: `http://www.ama-assn.org/go/cpt`
Direct Reference Code | Display: 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 Code: 99024 System: `http://www.ama-assn.org/go/cpt`
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`
Direct Reference Code | Display: Tobacco abuse counseling Code: Z71.6 System: `http://hl7.org/fhir/sid/icd-10-cm`
Direct Reference Code | Display: Fulfill the focal request Code: fulfill System: `http://hl7.org/fhir/CodeSystem/task-code`
Direct Reference Code | Display: Discharge to home for hospice care (procedure) Code: 428361000124107 System: `http://snomed.info/sct`
Direct Reference Code | Display: Discharge to healthcare facility for hospice care (procedure) Code: 428371000124100 System: `http://snomed.info/sct`
Direct Reference Code | Display: Hospice care [Minimum Data Set] Code: 45755-6 System: `http://loinc.org`
Direct Reference Code | Display: Yes (qualifier value) Code: 373066001 System: `http://snomed.info/sct`
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 Status Resource: https://madie.cms.gov/Library/Status|1.15.000 Canonical URL: `https://madie.cms.gov/Library/Status|1.15.000`
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`
Dependency | Description: Library CMD Resource: https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000 Canonical URL: `https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000`
Dependency | Description: Library Hospice Resource: https://madie.cms.gov/Library/Hospice|6.18.000 Canonical URL: `https://madie.cms.gov/Library/Hospice|6.18.000`
Data Requirements
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: extension, birthDate, birthDate.value, url
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1011
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period 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, status, status.value, period 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, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1496
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1141
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1530
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period, status, status.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
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/2.16.840.1.113883.3.464.1003.1003
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus Must Support Elements: effective, effective.value, status, status.value, value
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, performed, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.509
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, performed, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
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 Code(s): http://hl7.org/fhir/sid/icd-10-cm#Z71.6: 'Tobacco abuse counseling'
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/2.16.840.1.113883.3.464.1003.1165
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 Code(s): http://hl7.org/fhir/sid/icd-10-cm#Z71.6: 'Tobacco abuse counseling'
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/2.16.840.1.113883.3.464.1003.1165
Data Requirement | Type: Resource Profile(s): http://hl7.org/fhir/StructureDefinition/Resource Must Support Elements: id, id.value
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, intent, intent.value, authoredOn, authoredOn.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1190
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication.reference.value, status, status.value, intent, intent.value, authoredOn, authoredOn.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
Data Requirement | Type: Medication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication Must Support Elements: id.value, code
Data Requirement | Type: Task Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected Must Support Elements: focus, code
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/qicore/StructureDefinition/qicore-observation-screening-assessment Must Support Elements: code, value, effective, status, status.value Code Filter(s): Path: code Code(s): http://loinc.org#45755-6: 'Hospice care [Minimum Data Set]'
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Generated using version 0.4.8 of the sample-content-ig Liquid templates