Metadata
Title | Breast Cancer ScreeningFHIR
Version | 1.0.000
Short Name | CMS125FHIR
GUID (Version Independent) | urn:uuid:f766afa2-f780-45d2-b224-c1bdb733fa6f
GUID (Version Specific) | urn:uuid:ae8bc6fe-718d-4c4f-af2f-22aaf9c7844d
CMS Identifier | 125FHIR
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | National Committee for Quality Assurance
Developer | National Committee for Quality Assurance
Description | Percentage of women 40-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period
Copyright | This Physician Performance Measure (Measure) and related data specifications are owned and were developed 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. (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. Applicable FARS/DFARS restrictions apply to government use. 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 | Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al., 2018). In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Noone et al., 2018). While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Noone et al., 2018). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017).
Clinical Recommendation Statement | The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 40-74 years (B recommendation) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I statement) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography and magnetic resonance imaging in women identified to have dense breasts on an otherwise negative screening mammogram (I statement) (USPSTF, 2024). The National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) recommend using conventional mammography or DBT for screening women at low, intermediate or high risk for breast cancer (NCCN, 2021) (ACR, 2017).
Citation | American Cancer Society. (2017). Breast Cancer Facts & Figures 2017-2018. Retrieved February 8, 2019, from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf
Citation | American College of Radiology (ACR). (2017). ACR Appropriateness Criteria: Breast Cancer Screening. Retrieved from https://acsearch.acr.org/docs/70910/Narrative/
Citation | National Comprehensive Cancer Network (NCCN). (2021). Breast Cancer Screening and Diagnosis. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf
Citation | Noone, A.M., Howlader, N., Krapcho, M., Miller, D., Brest, A., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., Lewis, D.R., Chen, H.S., Feuer, E.J., Cronin, K.A. (eds). (2018). SEER Cancer Statistics Review, 1975-2015. National Cancer Institute. Bethesda, MD. Retrieved February 8, 2019, from https://seer.cancer.gov/csr/1975_2015/
Citation | U.S. Preventive Services Task Force (2024). Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534.
Guidance (Usage) | This measure evaluates primary screening. Do not count biopsies, breast ultrasounds, or MRIs because they are not appropriate methods for primary breast cancer screening. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS125v14. 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: Women 42-74 years of age by the end of the measurement period with a visit during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Equals Initial Population Logic Definition: Denominator
Denominator Exclusion | ID: DenominatorExclusion_1 Description: Exclude patients who are in hospice care for any part of the measurement period. Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: Women with one or more mammograms any time on or between October 1 two years prior to the measurement period and the end of the measurement period Logic Definition: Numerator
Stratifier | ID: Stratification_1_1 Description: Report a total rate, and each of the following age strata: Stratum 1: Patients age 42-51 by the end of the measurement period
Stratifier | ID: Stratification_1_2 Description: Stratum 2: Patients age 52-74 by the end of the measurement period
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/CMS125FHIRBreastCancerScreen
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
        end of "Measurement Period"
      ) in Interval[42, 74]
        and Patient.sex = '248152002'
        and exists AdultOutpatientEncounters."Qualifying Encounters"
Denominator
    define "Denominator":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
        or ( ( exists ( "Right Mastectomy Diagnosis" )
              or exists ( "Right Mastectomy Procedure" )
          )
            and ( exists ( "Left Mastectomy Diagnosis" )
                or exists ( "Left Mastectomy Procedure" )
            )
        )
        or exists "Bilateral Mastectomy Diagnosis"
        or exists "Bilateral Mastectomy Procedure"
        or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
        or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
        or PalliativeCare."Has Palliative Care in the Measurement Period"
Numerator
    define "Numerator":
      exists ( ( [ObservationClinicalResult: "Mammography"] ).isDiagnosticStudyPerformed ( ) ) Mammogram
        where Mammogram.effective.toInterval ( ) ends during day of Interval["October 1 Two Years Prior to the Measurement Period", end of "Measurement Period"]
Stratifier
    define "Stratification 1":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[42, 51]
Stratifier
    define "Stratification 2":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[52, 74]
Logic Definitions
Logic Definition | Library Name: AdultOutpatientEncounters
    define "Qualifying Encounters":
      ( ( [Encounter: "Office Visit"]
        union [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: "Home Healthcare Services"]
        union [Encounter: "Virtual Encounter"]
        union [Encounter: "Telephone Visits"] ).isEncounterPerformed() ) ValidEncounter
        where ValidEncounter.period during day of "Measurement Period"
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: AdvancedIllnessandFrailty
    define "Has Criteria Indicating Frailty":
      exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrderPersonalUseDevices()) FrailtyDeviceOrder
          where FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period"
      )
        or exists ( (([ObservationScreeningAssessment: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed
            where EquipmentUsed.value as Concept in "Frailty Device"
            and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period"
        )
        or exists ( (([ConditionProblemsHealthConcerns: "Frailty Diagnosis"]
        union [ConditionEncounterDiagnosis: "Frailty Diagnosis"]).verified()) FrailtyDiagnosis
            where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
        )
        or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter
            where FrailtyEncounter.period overlaps day of "Measurement Period"
        )
        or exists ( (([SimpleObservation: "Frailty Symptom"]).isSymptom()) FrailtySymptom
            where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period"
        )
Logic Definition | Library Name: AdvancedIllnessandFrailty
    define "Has Advanced Illness in Year Before or During Measurement Period":
    exists ((([ConditionProblemsHealthConcerns: "Advanced Illness"]
    union [ConditionEncounterDiagnosis: "Advanced Illness"]).verified()) AdvancedIllnessDiagnosis
    where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])
Logic Definition | Library Name: AdvancedIllnessandFrailty
    define "Has Dementia Medications in Year Before or During Measurement Period":
      exists (( ([MedicationRequest: "Dementia Medications"]).isMedicationActive()) DementiaMedication
          where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year,
            end of "Measurement Period"]
      )
Logic Definition | Library Name: AdvancedIllnessandFrailty
    define "Is Age 66 or Older with Advanced Illness and Frailty":
       AgeInYearsAt(date from end of "Measurement Period")>= 66
        and "Has Criteria Indicating Frailty"
        and ( "Has Advanced Illness in Year Before or During Measurement Period"
            or "Has Dementia Medications in Year Before or During Measurement Period"
        )
Logic Definition | Library Name: AdvancedIllnessandFrailty
    define "Is Age 66 or Older Living Long Term in a Nursing Home":
      AgeInYearsAt(date from
         end of "Measurement Period"
      )>= 66
        and ( ( Last( (([ObservationScreeningAssessment: "Housing status"]).isAssessmentPerformed()) HousingStatus
              where HousingStatus.effective.toInterval() ends on or before
              day of end of "Measurement Period"
              sort by
              end of effective.toInterval() asc
          )) LastHousingStatus
            where LastHousingStatus.value ~ "Lives in nursing home (finding)"
        ) is not null
Logic Definition | Library Name: PalliativeCare
    define "Has Palliative Care in the Measurement Period":
      exists ((([ObservationScreeningAssessment: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment
          where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"
      )
        or exists ((([ConditionProblemsHealthConcerns: "Palliative Care Diagnosis"]
        union [ConditionEncounterDiagnosis: "Palliative Care Diagnosis"]).verified()) PalliativeDiagnosis
            where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
        )
        or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter
            where PalliativeEncounter.period overlaps day of "Measurement Period"
        )
        or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention
            where PalliativeIntervention.performed.toInterval() 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: CMS125FHIRBreastCancerScreen
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "October 1 Two Years Prior to the Measurement Period":
      DateTime((year from start of "Measurement Period" - 2), 10, 1, 0, 0, 0, 0, 0)
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Numerator":
      exists ( ( [ObservationClinicalResult: "Mammography"] ).isDiagnosticStudyPerformed ( ) ) Mammogram
        where Mammogram.effective.toInterval ( ) ends during day of Interval["October 1 Two Years Prior to the Measurement Period", end of "Measurement Period"]
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Stratification 2":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[52, 74]
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Stratification 1":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[42, 51]
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Initial Population":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[42, 74]
        and Patient.sex = '248152002'
        and exists AdultOutpatientEncounters."Qualifying Encounters"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Denominator":
      "Initial Population"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Right Mastectomy Diagnosis":
      ( ( ( [ConditionEncounterDiagnosis: "Status Post Right Mastectomy"]
          union [ConditionProblemsHealthConcerns: "Status Post Right Mastectomy"] ) RightMastectomyProcedure
          union ( ( [ConditionEncounterDiagnosis: "Unilateral Mastectomy, Unspecified Laterality"]
              union [ConditionProblemsHealthConcerns: "Unilateral Mastectomy, Unspecified Laterality"] ) UnilateralMastectomyDiagnosis
              where exists UnilateralMastectomyDiagnosis.bodySite S
                where S ~ "Right (qualifier value)"
          )
      ).verified ( ) ) RightMastectomy
        where RightMastectomy.prevalenceInterval ( ) starts on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Right Mastectomy Procedure":
      ( ( [Procedure: "Unilateral Mastectomy Right"] ).isProcedurePerformed ( ) ) UnilateralMastectomyRightPerformed
        where UnilateralMastectomyRightPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Left Mastectomy Diagnosis":
      ( ( ( [ConditionEncounterDiagnosis: "Status Post Left Mastectomy"]
            union [ConditionProblemsHealthConcerns: "Status Post Left Mastectomy"]
        )
          union ( ( [ConditionEncounterDiagnosis: "Unilateral Mastectomy, Unspecified Laterality"]
              union [ConditionProblemsHealthConcerns: "Unilateral Mastectomy, Unspecified Laterality"] ) UnilateralMastectomyDiagnosis
              where exists UnilateralMastectomyDiagnosis.bodySite S
                where S ~ "Left (qualifier value)"
          )
      ).verified ( ) ) LeftMastectomy
        where LeftMastectomy.prevalenceInterval ( ) starts on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Left Mastectomy Procedure":
      ( ( [Procedure: "Unilateral Mastectomy Left"] ).isProcedurePerformed ( ) ) UnilateralMastectomyLeftPerformed
        where UnilateralMastectomyLeftPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Bilateral Mastectomy Diagnosis":
      ( ( [ConditionEncounterDiagnosis: "History of bilateral mastectomy"]
          union [ConditionProblemsHealthConcerns: "History of bilateral mastectomy"]
      ).verified ( ) ) BilateralMastectomyHistory
        where BilateralMastectomyHistory.prevalenceInterval ( ) starts on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Bilateral Mastectomy Procedure":
      ( ( [Procedure: "Bilateral Mastectomy"] ).isProcedurePerformed ( ) ) BilateralMastectomyPerformed
        where BilateralMastectomyPerformed.performed.toInterval ( ) ends on or before end of "Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "Denominator Exclusions":
      Hospice."Has Hospice Services"
        or ( ( exists ( "Right Mastectomy Diagnosis" )
              or exists ( "Right Mastectomy Procedure" )
          )
            and ( exists ( "Left Mastectomy Diagnosis" )
                or exists ( "Left Mastectomy Procedure" )
            )
        )
        or exists "Bilateral Mastectomy Diagnosis"
        or exists "Bilateral Mastectomy Procedure"
        or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
        or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
        or PalliativeCare."Has Palliative Care in the Measurement Period"
Logic Definition | Library Name: CMS125FHIRBreastCancerScreen
    define "SDE Race":
      SDE."SDE Race"
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: Status
    //Diagnostic Study, Performed
    define fluent function isDiagnosticStudyPerformed(Obs List<ObservationClinicalResult>):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }
            and exists ( O.category ObservationCategory
            where ( ObservationCategory ) ~ "imaging"
        )
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
    //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'}
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
    //Procedure, Performed
    define fluent function isProcedurePerformed(Proc List<Procedure>):
      Proc P
        where P.status ~ 'completed'
Logic Definition | Library Name: Status
    //Device, Order - Personal Use Devices
    define fluent function isDeviceOrderPersonalUseDevices(DeviceRequest List<DeviceRequest>):
      DeviceRequest D
        where D.status in { 'active', 'completed' }
          and D.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Status
    //Symptom
    define fluent function isSymptom(Obs List<SimpleObservation>):
      Obs O
        where O.status in { 'preliminary', 'final', 'amended', 'corrected' }
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: 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
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system ObservationCategoryCodes Resource: http://terminology.hl7.org/CodeSystem/observation-category Canonical URL: `http://terminology.hl7.org/CodeSystem/observation-category`
Code System | Description: Code system LOINC Resource: http://loinc.org Canonical URL: `http://loinc.org`
Code System | Description: Code system ConditionVerificationStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-ver-status Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Value Set | Description: Value set Mammography Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018`
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 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 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 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 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 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`
Value Set | Description: Value set Status Post Right Mastectomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070`
Value Set | Description: Value set Unilateral Mastectomy, Unspecified Laterality Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071`
Value Set | Description: Value set Unilateral Mastectomy Right Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1134 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1134`
Value Set | Description: Value set Status Post Left Mastectomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069`
Value Set | Description: Value set Unilateral Mastectomy Left Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1133 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1133`
Value Set | Description: Value set History of bilateral mastectomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068`
Value Set | Description: Value set Bilateral Mastectomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005`
Value Set | Description: Value set Frailty Device Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300`
Value Set | Description: Value set Frailty Diagnosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074`
Value Set | Description: Value set Frailty Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088`
Value Set | Description: Value set Frailty Symptom Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075`
Value Set | Description: Value set Advanced Illness Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082`
Value Set | Description: Value set Dementia Medications Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510`
Value Set | Description: Value set Palliative Care Diagnosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167`
Value Set | Description: Value set Palliative Care Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090`
Value Set | Description: Value set Palliative Care Intervention Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135`
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: imaging Code: imaging System: `http://terminology.hl7.org/CodeSystem/observation-category`
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`
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: Right (qualifier value) Code: 24028007 System: `http://snomed.info/sct`
Direct Reference Code | Display: Left (qualifier value) Code: 7771000 System: `http://snomed.info/sct`
Direct Reference Code | Display: Medical equipment used Code: 98181-1 System: `http://loinc.org`
Direct Reference Code | Display: Housing status Code: 71802-3 System: `http://loinc.org`
Direct Reference Code | Display: Lives in nursing home (finding) Code: 160734000 System: `http://snomed.info/sct`
Direct Reference Code | Display: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal) Code: 71007-9 System: `http://loinc.org`
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 AdultOutpatientEncounters Resource: https://madie.cms.gov/Library/AdultOutpatientEncounters|4.19.000 Canonical URL: `https://madie.cms.gov/Library/AdultOutpatientEncounters|4.19.000`
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`
Dependency | Description: Library AIFrailLTCF Resource: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.27.000 Canonical URL: `https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.27.000`
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 PalliativeCare Resource: https://madie.cms.gov/Library/PalliativeCare|1.18.000 Canonical URL: `https://madie.cms.gov/Library/PalliativeCare|1.18.000`
Data Requirements
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: extension, url, birthDate, birthDate.value
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-clinical-result Must Support Elements: code, effective, status, status.value, category Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018
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/2.16.840.1.113883.3.526.3.1240
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/2.16.840.1.113883.3.464.1003.101.12.1016
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/2.16.840.1.113883.3.464.1003.101.12.1089
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/2.16.840.1.113883.3.464.1003.101.12.1080
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: 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/2.16.840.1.113883.3.464.1003.101.12.1088
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/2.16.840.1.113883.3.464.1003.101.12.1090
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: 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#98181-1: 'Medical equipment used'
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment Must Support Elements: code, effective, status, status.value, value Code Filter(s): Path: code Code(s): http://loinc.org#71802-3: 'Housing status'
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment Must Support Elements: code, effective, status, status.value Code Filter(s): Path: code Code(s): http://loinc.org#71007-9: 'Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)'
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
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: 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/2.16.840.1.113883.3.464.1003.198.12.1134
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/2.16.840.1.113883.3.464.1003.198.12.1133
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/2.16.840.1.113883.3.464.1003.198.12.1005
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/2.16.840.1.113883.3.464.1003.198.12.1135
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-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070
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/2.16.840.1.113883.3.464.1003.198.12.1069
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/2.16.840.1.113883.3.464.1003.198.12.1071
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/2.16.840.1.113883.3.464.1003.198.12.1068
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/2.16.840.1.113883.3.464.1003.113.12.1074
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
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: 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/2.16.840.1.113883.3.464.1003.198.12.1070
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/2.16.840.1.113883.3.464.1003.198.12.1069
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/2.16.840.1.113883.3.464.1003.198.12.1071
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/2.16.840.1.113883.3.464.1003.198.12.1068
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/2.16.840.1.113883.3.464.1003.113.12.1074
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Data Requirement | Type: DeviceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest Must Support Elements: code, status, status.value, intent, intent.value, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: code, effective, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075
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, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510
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, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod
Data Requirement | Type: Medication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication Must Support Elements: id.value, code
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