Metadata
Title | Severe Obstetric ComplicationsFHIR
Version | 1.0.000
Short Name | CMS1028FHIR
GUID (Version Independent) | urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7
GUID (Version Specific) | urn:uuid:d2400512-5e4e-433c-8a5c-0a85be20e660
CMS Identifier | 1028FHIR
CMS Consensus Based Entity Identifier | 3687e
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | The Joint Commission
Developer | The Joint Commission
Developer | Centers for Medicare & Medicaid Services (CMS)
Developer | Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation
Description | Patients with severe obstetric complications that occur during the inpatient delivery hospitalization
Copyright | Measure specifications are in the Public Domain. LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.
Disclaimer | These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.
Rationale | The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. The Centers for Disease Control and Prevention (CDC) (2021) report that these rates have continued to trend upward in recent decades. Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2020). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, & Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, & Kuklina, 2012). There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.
Clinical Recommendation Statement | Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.). The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, Kilpatrick, & Ecker, 2016).
Citation | American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. (2016, September 01). Severe maternal morbidity: Screening and review. American Journal of Obstetrics & Gynecology, 215(3), B17-B22. http://dx.doi.org/https://doi.org/10.1016/j.ajog.2016.07.050
Citation | Centers for Disease Control and Prevention. Severe maternal morbidity in the United States. January 31, 2020; https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
Citation | Hoyert DL, Minino AM. Maternal mortality in the United States: changes in coding, publication, and data release, 2018. National Vital Statistics Report, 69(2), 2020.
Citation | Leonard SA, Main EK, Carmichael SL. The contribution of maternal characteristics and cesarean delivery to an increasing trend of severe maternal morbidity. BMC Pregnancy Childbirth. BMC Pregnancy Childbirth. 2019 Jan 9;19(1):16. doi: 10.1186/s12884-018-2169-3.
Citation | Leonard SA, Main EK, Scott KA, Profit J, Carmichael SL. Racial and ethnic disparities in severe maternal morbidity prevalence and trends. Ann Epidemiol. 2019 Feb 28. pii: S1047-2797(18)30899-8.
Citation | Leonard, S. A., Kennedy, C. J., Carmichael, S. L., Lyell, D. J., & Main, E. K. (2020). An Expanded Obstetric Comorbidity Scoring System for Predicting Severe Maternal Morbidity. Obstetrics and gynecology, 136(3), 440-449. https://doi.org/10.1097/AOG.0000000000004022
Citation | Main, E. K., Leonard, S. A., & Menard, M. K. (2020). Association of Maternal Comorbidity With Severe Maternal Morbidity: A Cohort Study of California Mothers Delivering Between 1997 and 2014. Annals of internal medicine, 173(11 Suppl), S11-S18. https://doi.org/10.7326/M19-3253
Citation | Office of Disease Prevention and Health Promotion. (n.d.). Reduce severe maternal complications identified during delivery hospitalization- MICH-05. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth/reduce-severe-maternal-complications-identified-during-delivery-hospitalizations-mich-05
Citation | U.S. Department of Health and Human Services. HHS Outlines New Plans and a Partnership to Reduce U.S. Pregnancy-related Deaths. 2020; https://www.hhs.gov/about/news/2020/12/03/hhs-outlines-new-plans-to-reduce-us-pregnancy-related-deaths.html.
Definition | Severe Obstetric Complications (SOC): For this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).
Guidance (Usage) | Note: This measure will be stratified by race/ethnicity and payer after measure submission. In the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence: The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.* When the calculated GA is not available, the GA is obtained from a discrete field in the electronic health record. The intent is to capture the last estimated GA in the interval starting 24 hours or less prior to delivery and ending before midnight on the same day of delivery. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available. *ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): Gestational Age = (280-(Estimated Due Date minus Reference Date)) / 7 Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) Reference Date is the date on which you are trying to determine gestational age. For purposes of this dQM, Reference Date would be the Date of Delivery. Note however, the calculation may yield a non-whole number, and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks. This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS1028v4. 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)
Summary | All Severe Obstetric Complications (SOC)
Basis | Encounter
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']
Rate Aggregation | Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Numerator 1 - Numerator Exclusions 1) / Denominator) * 10,000 delivery hospitalizations 2. SOC excluding encounters where transfusion was the only SOC. ((Numerator 2 - Numerator Exclusions 2) / Denominator) * 10,000 delivery hospitalizations Numerator 1: Delivery encounters with SOC Numerator 2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC Numerator Exclusions 1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs Numerator Exclusions 2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Denominator: Delivery encounters with > or = 20 weeks' gestation completed
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#decrease: 'Decreased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed Logic Definition: Denominator
Numerator | ID: Numerator_1 Description: All Severe Obstetric Complications (SOC). Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: Severe maternal morbidity diagnoses (see list below) Severe maternal morbidity procedures (see list below) Discharge disposition of expired Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff. Severe Maternal Morbidity Diagnoses: Cardiac Acute heart failure Acute myocardial infarction Aortic aneurysm Cardiac arrest/ventricular fibrillation Heart failure/arrest during procedure or surgery Hemorrhage Disseminated intravascular coagulation Shock Renal Acute renal failure Respiratory Adult respiratory distress syndrome Pulmonary edema Sepsis Other OB Air and thrombotic embolism Amniotic fluid embolism Eclampsia Severe anesthesia complications Other Medical Puerperal cerebrovascular disorder Sickle cell disease with crisis Severe Maternal Morbidity Procedures: Blood transfusion Conversion of cardiac rhythm Hysterectomy Temporary tracheostomy Ventilation Logic Definition: Numerator 1
Numerator Exclusion | ID: NumeratorExclusion_1 Description: Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications Logic Definition: Numerator Exclusions 1
Measure Group (Rate) (ID: Group_2)
Summary | SOC excluding encounters where transfusion was the only SOC
Basis | Encounter
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']
Rate Aggregation | Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Numerator 1 – Numerator Exclusions 1) / Denominator) * 10,000 delivery hospitalizations 2. SOC excluding encounters where transfusion was the only SOC. ((Numerator 2 – Numerator Exclusions 2) / Denominator) * 10,000 delivery hospitalizations Numerator 1: Delivery encounters with SOC Numerator 2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC Numerator Exclusions 1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs Numerator Exclusions 2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Denominator: Delivery encounters with > or = 20 weeks' gestation completed
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#decrease: 'Decreased score indicates improvement']
Initial Population | ID: InitialPopulation_2 Description: Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_2 Description: Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed Logic Definition: Denominator
Numerator | ID: Numerator_2 Description: Delivery encounters with SOC excluding encounters where transfusion was the only SOC. Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including: Severe maternal morbidity diagnoses (see following list) Severe maternal morbidity procedures (see following list) Discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. Severe Maternal Morbidity Diagnoses: Cardiac Acute heart failure Acute myocardial infarction Aortic aneurysm Cardiac arrest/ventricular fibrillation Heart failure/arrest during procedure or surgery Hemorrhage Disseminated intravascular coagulation Shock Renal Acute renal failure Respiratory Adult respiratory distress syndrome Pulmonary edema Sepsis Other OB Air and thrombotic embolism Amniotic fluid embolism Eclampsia Severe anesthesia complications Other Medical Puerperal cerebrovascular disorder Sickle cell disease with crisis Severe Maternal Morbidity Procedures: Blood transfusion Conversion of cardiac rhythm Hysterectomy Temporary tracheostomy Ventilation Logic Definition: Numerator 2
Numerator Exclusion | ID: NumeratorExclusion_2 Description: Inpatient hospitalizations with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications Logic Definition: Numerator Exclusions 2
Supplemental Data Guidance | For every patient evaluated by this measure also identify payer, race, ethnicity and sex. No additional supplemental data elements are required to be submitted by reporting entities; all other needed data points are calculated following data receipt.
Supplemental Data Guidance | Please see the included Severe Obstetric Complications Risk Adjustment Methodology Report. Pre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, & Main, 2020; Main, Leonard, & Menard, 2020). Anemia (includes sickle cell disease) Asthma Autoimmune Disease Bariatric Surgery Bleeding Disorder Cardiac Disease Economic Housing Instability Gastrointestinal Disease Gestational Diabetes HIV Hypertension Long-term Anticoagulant Use Maternal Age (derived from birthdate) Mental Health Disorder Morbid Obesity Multiple Pregnancy Neuromuscular Disease Obstetric VTE Other Pre-eclampsia Placenta Previa Placental Abruption Placental Accreta Spectrum Pre-existing Diabetes Preterm Birth Previous Cesarean Pulmonary Hypertension Renal Disease Severe Pre-eclampsia Substance Abuse Thyrotoxicosis Lab and Physical Exam Results: Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified: Heart rate: {beats}/min Systolic blood pressure: mm[Hg] Hematocrit: % White blood cell count: 10*3/uL
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
Supplemental Data Element | ID: sde-delivery-encounters-with-severe-obstetric-complication-diagnosis Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Delivery Encounters With Severe Obstetric Complication Diagnosis Logic Definition: SDE Delivery Encounters With Severe Obstetric Complication Diagnosis
Supplemental Data Element | ID: sde-soc-diagnoses-detail Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE SOC Diagnoses Detail Logic Definition: SDE SOC Diagnoses Detail
Supplemental Data Element | ID: sde-soc-procedure-detail Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE SOC Procedure Detail Logic Definition: SDE SOC Procedure Detail
Supplemental Data Element | ID: sde-variable-calculated-gestational-age Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Variable Calculated Gestational Age Logic Definition: SDE Variable Calculated Gestational Age
Supplemental Data Element | ID: sde-delivery-encounters-with-severe-obstetric-complication-procedures Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Delivery Encounters With Severe Obstetric Complication Procedures Logic Definition: SDE Delivery Encounters With Severe Obstetric Complication Procedures
Supplemental Data Element | ID: risk-variable-anemia Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Anemia Logic Definition: Risk Variable Anemia
Supplemental Data Element | ID: risk-variable-asthma Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Asthma Logic Definition: Risk Variable Asthma
Supplemental Data Element | ID: risk-variable-autoimmune-disease Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Autoimmune Disease Logic Definition: Risk Variable Autoimmune Disease
Supplemental Data Element | ID: risk-variable-bariatric-surgery Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Bariatric Surgery Logic Definition: Risk Variable Bariatric Surgery
Supplemental Data Element | ID: risk-variable-bleeding-disorder Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Bleeding Disorder Logic Definition: Risk Variable Bleeding Disorder
Supplemental Data Element | ID: risk-variable-cardiac-disease Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Cardiac Disease Logic Definition: Risk Variable Cardiac Disease
Supplemental Data Element | ID: risk-variable-economic-housing-instability Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Economic Housing Instability Logic Definition: Risk Variable Economic Housing Instability
Supplemental Data Element | ID: risk-variable-gastrointestinal-disease Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Gastrointestinal Disease Logic Definition: Risk Variable Gastrointestinal Disease
Supplemental Data Element | ID: risk-variable-gestational-diabetes Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Gestational Diabetes Logic Definition: Risk Variable Gestational Diabetes
Supplemental Data Element | ID: risk-variable-hiv Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable HIV Logic Definition: Risk Variable HIV
Supplemental Data Element | ID: risk-variable-hypertension Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Hypertension Logic Definition: Risk Variable Hypertension
Supplemental Data Element | ID: risk-variable-long-term-anticoagulant-use Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Long Term Anticoagulant Use Logic Definition: Risk Variable Long Term Anticoagulant Use
Supplemental Data Element | ID: risk-variable-maternal-age Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Maternal Age Logic Definition: Risk Variable Maternal Age
Supplemental Data Element | ID: risk-variable-mental-health-disorder Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Mental Health Disorder Logic Definition: Risk Variable Mental Health Disorder
Supplemental Data Element | ID: risk-variable-morbid-obesity Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Morbid Obesity Logic Definition: Risk Variable Morbid Obesity
Supplemental Data Element | ID: risk-variable-multiple-pregnancy Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Multiple Pregnancy Logic Definition: Risk Variable Multiple Pregnancy
Supplemental Data Element | ID: risk-variable-obstetrical-vte Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Obstetrical VTE Logic Definition: Risk Variable Obstetrical VTE
Supplemental Data Element | ID: risk-variable-other-preeclampsia Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Other Preeclampsia Logic Definition: Risk Variable Other Preeclampsia
Supplemental Data Element | ID: risk-variable-placenta-previa Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Placenta Previa Logic Definition: Risk Variable Placenta Previa
Supplemental Data Element | ID: risk-variable-placental-abruption Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Placental Abruption Logic Definition: Risk Variable Placental Abruption
Supplemental Data Element | ID: risk-variable-placental-accreta-spectrum Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Placental Accreta Spectrum Logic Definition: Risk Variable Placental Accreta Spectrum
Supplemental Data Element | ID: risk-variable-preexisting-diabetes Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Preexisting Diabetes Logic Definition: Risk Variable Preexisting Diabetes
Supplemental Data Element | ID: risk-variable-previous-cesarean Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Previous Cesarean Logic Definition: Risk Variable Previous Cesarean
Supplemental Data Element | ID: risk-variable-pulmonary-hypertension Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Pulmonary Hypertension Logic Definition: Risk Variable Pulmonary Hypertension
Supplemental Data Element | ID: risk-variable-renal-disease Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Renal Disease Logic Definition: Risk Variable Renal Disease
Supplemental Data Element | ID: risk-variable-severe-preeclampsia Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Severe Preeclampsia Logic Definition: Risk Variable Severe Preeclampsia
Supplemental Data Element | ID: risk-variable-substance-abuse Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Substance Abuse Logic Definition: Risk Variable Substance Abuse
Supplemental Data Element | ID: risk-variable-thyrotoxicosis Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Thyrotoxicosis Logic Definition: Risk Variable Thyrotoxicosis
Supplemental Data Element | ID: risk-variable-preterm-birth Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Preterm Birth Logic Definition: Risk Variable Preterm Birth
Supplemental Data Element | ID: risk-variable-first-hematocrit-lab-test Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable First Hematocrit Lab Test Logic Definition: Risk Variable First Hematocrit Lab Test
Supplemental Data Element | ID: risk-variable-first-white-blood-cell-count-lab-test Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable First White Blood Cell Count Lab Test Logic Definition: Risk Variable First White Blood Cell Count Lab Test
Supplemental Data Element | ID: risk-variable-heart-rate Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Heart Rate Logic Definition: Risk Variable Heart Rate
Supplemental Data Element | ID: risk-variable-systolic-blood-pressure Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Systolic Blood Pressure Logic Definition: Risk Variable Systolic Blood Pressure
Supplemental Data Element | ID: risk-variable-neuromuscular-disease Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Neuromuscular Disease Logic Definition: Risk Variable Neuromuscular Disease
Measure Logic
Primary Library | https://madie.cms.gov/Library/CMS1028FHIRPCSevereOBComps
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      PCMaternal."Delivery Encounter With Age Range"
Denominator
    define "Denominator":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation"
Numerator
    define "Numerator 1":
      "Delivery Encounters With Severe Obstetric Complications"
Numerator Exclusion
    define "Numerator Exclusions 1":
      "SOC With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC"
Measure Group (Rate) (ID: Group_2)
Initial Population
    define "Initial Population":
      PCMaternal."Delivery Encounter With Age Range"
Denominator
    define "Denominator":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation"
Numerator
    define "Numerator 2":
      "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions Only"
Numerator Exclusion
    define "Numerator Exclusions 2":
      "SOC Excluding Blood Transfusions Only With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC"
Logic Definitions
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 Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
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 Ethnicity":
      Patient.ethnicity E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }
Logic Definition | Library Name: PCMaternal
    define "Encounter With Age Range":
     CQMCommon."Inpatient Encounter" InpatientEncounter
                          where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )
Logic Definition | Library Name: PCMaternal
    define "Delivery Encounter With Age Range":
      "Encounter With Age Range" EncounterWithAge
                    with ["Procedure": "Delivery Procedures"] DeliveryProcedure
                    such that DeliveryProcedure.status = 'completed'
                    and DeliveryProcedure.performed.toInterval  ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()
Logic Definition | Library Name: PCMaternal
    define "Variable Calculated Gestational Age":
     "Delivery Encounter With Age Range" DeliveryEncounter
        let CGA: DeliveryEncounter.calculatedGestationalAge()
        return {
          EncounterID: DeliveryEncounter.id,
          CalculatedCGA: CGA
        }
Logic Definition | Library Name: PCMaternal
    define fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):
      /*hospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter*/
      TheEncounter Visit
        let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
            where LastObs.period ends 1 hour or less on or before start of Visit.period
              and LastObs.status = 'finished'
            sort by
            end of period
        ),
        VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
        EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
            where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
              and LastEDOBTriage.status = 'finished'
            sort by
            end of period
        )
        return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart),
        end of Visit.period]
Logic Definition | Library Name: PCMaternal
    define fluent function calculatedGestationalAge (TheEncounter Encounter ):
      //Gestational Age = (280 -(Estimated Delivery Date minus Reference Date/Delivery Date))/7
     ( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7
Logic Definition | Library Name: PCMaternal
    define fluent function lastTimeOfDelivery (TheEncounter Encounter ):
      Last(["SimpleObservation": "Date and time of obstetric delivery"] TimeOfDelivery
          where TimeOfDelivery.value as DateTime is not null
            and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }
            and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()
            and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()
          sort by effective.earliest()
      ).value as DateTime
Logic Definition | Library Name: PCMaternal
    define fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):
      /*This function identifies the last time the EDD was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.*/
      Last(["SimpleObservation": "Delivery date Estimated"] EstimatedDateOfDelivery
          where EstimatedDateOfDelivery.value as DateTime is not null
            and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }
            and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()
          sort by effective.earliest ( )
      ).value as DateTime
Logic Definition | Library Name: PCMaternal
    define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
      Last(["SimpleObservation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
      let EGATiming:  EstimatedGestationalAge.effective.earliest() where
      (EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
      and EstimatedGestationalAge.value is not null
      and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or
          (EGATiming same day as TheEncounter.lastTimeOfDelivery ()
          and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation()
          and EstimatedGestationalAge.value is not null)
     sort by effective.earliest ())
             .value as Quantity
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: Given an interval, return the starting point if the interval has a starting boundary specified,
    otherwise, return the ending point
    */
    define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
      (choice.toInterval()) period
        return
          if (period."hasStart"()) then start of period
          else end of period
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Given an interval, return true if the interval has a starting boundary specified
    (i.e. the start of the interval is not null and not the minimum DateTime value)
    */
    define fluent function hasStart(period Interval<DateTime> ):
      not ( start of period is null
          or start of period = minimum DateTime
      )
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if the given reference is to the given resourceId
    @comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference Reference, resourceId String):
      resourceId = Last(Split(reference.reference, '/'))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if any of the given references are to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(references List<Reference>, resource Resource):
      exists (references R where R.references(resource))
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: CQMCommon
    define "Inpatient Encounter":
      [Encounter: "Encounter Inpatient"] EncounterInpatient
        where EncounterInpatient.status = 'finished'
          and EncounterInpatient.period ends during day of "Measurement Period"
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the Condition resources referenced by the diagnosis element of the Encounter
    */
    define fluent function encounterDiagnosis(Encounter Encounter ):
      Encounter.reasonReference D
        return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))
Logic Definition | Library Name: CQMCommon
    /*
     @description: Returns true if the given diagnosis is present on admission, based on the given poaValueSet
     @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
     */
     define fluent function isDiagnosisPresentOnAdmission(encounter Encounter, diagnosisValueSet ValueSet, poaValueSet ValueSet):
       exists (
         (encounter.claimDiagnosis()) CD
           where CD.onAdmission in poaValueSet
             and (
               CD.diagnosis in diagnosisValueSet
                 or CD.diagnosis.getCondition().code in diagnosisValueSet
             )
       )
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the claim diagnosis elements for the given encounter
    @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
    */
    define fluent function claimDiagnosis(encounter Encounter):
      encounter E
        let
          claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
          claimItem: (claim.item I where I.encounter.references(E))
        return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the Condition resource for the given reference
    */
    define fluent function getCondition(reference Reference):
      singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
    value to a CQL DateTime Interval
    @comment: If the start value of the given period is unspecified, the starting
    boundary of the resulting interval will be open (meaning the start of the interval
    is unknown, as opposed to interpreted as the beginning of time).
    */
    define function ToInterval(period FHIR.Period):
        if period is null then
            null
        else
            if period."start" is null then
                Interval(period."start".value, period."end".value]
            else
                Interval[period."start".value, period."end".value]
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [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
    define function ToString(value uri): value.value
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Calculated Gestational Age Greater Than Or Equal To 20 Weeks":
      PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
        where DeliveryEncounter.calculatedGestationalAge ( ) >= 20
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Estimated Gestational Age Assessment Greater Than Or Equal To 20 Weeks":
      PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
        where DeliveryEncounter.calculatedGestationalAge ( ) is null
          and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Gestational Age Greater Than Or Equal To 20 Weeks Based On Coding":
      PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
        where DeliveryEncounter.calculatedGestationalAge ( ) is null
          and DeliveryEncounter.lastEstimatedGestationalAge ( ) is null
          and ( DeliveryEncounter.reasonCode in "20 to 42 Plus Weeks Gestation"
              or DeliveryEncounter.encounterDiagnosis ( ).code in "20 to 42 Plus Weeks Gestation"
          )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation":
      "Delivery Encounters With Calculated Gestational Age Greater Than Or Equal To 20 Weeks"
        union "Delivery Encounters With Estimated Gestational Age Assessment Greater Than Or Equal To 20 Weeks"
        union "Delivery Encounters With Gestational Age Greater Than Or Equal To 20 Weeks Based On Coding"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Asthma":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Acute or Persistent Asthma", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Severe Obstetric Complications Diagnosis Or Procedure Excluding Blood Transfusion":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Severe Maternal Morbidity Diagnoses", "Present on Admission is No or Unable To Determine" )
          or ( exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] SMMProcedures
                where SMMProcedures.status = 'completed'
                  and SMMProcedures.performed.toInterval ( ) starts during TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
            )
          )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Expiration":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Blood Transfusion":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with ["Procedure": "Blood Transfusion"] BloodTransfusion
          such that BloodTransfusion.status = 'completed'
            and BloodTransfusion.performed.toInterval ( ) starts during TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Severe Obstetric Complications":
      "Delivery Encounters With Severe Obstetric Complications Diagnosis Or Procedure Excluding Blood Transfusion"
        union "Delivery Encounters With Expiration"
        union "Delivery Encounters With Blood Transfusion"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Hysterectomy":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with ["Procedure": "Hysterectomy"] Hysterectomy
          such that Hysterectomy.status = 'completed'
            and Hysterectomy.performed.toInterval ( ) starts during TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Cardiac Conversion, Tracheostomy Or Ventilation Procedures":
      ["Procedure": "Conversion of Cardiac Rhythm"]
        union ["Procedure": "Tracheostomy"]
        union ["Procedure": "Ventilation"]
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Cardiac Conversion, Tracheostomy Or Ventilation Procedures":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with "Cardiac Conversion, Tracheostomy Or Ventilation Procedures" ConvTrachVentProcedures
          such that ConvTrachVentProcedures.status = 'completed'
            and ConvTrachVentProcedures.performed.toInterval ( ) starts during TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SOC With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters With Severe Obstetric Complications" SOCEncounter
          where ( SOCEncounter.reasonCode in "Placenta Increta or Percreta"
              or SOCEncounter.encounterDiagnosis ( ).code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters With Blood Transfusion"
                or exists "Delivery Encounters With Hysterectomy"
            )
      )
    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy

        except ( ( "Delivery Encounters With Severe Obstetric Complications" SOCEncounter
              where SOCEncounter.isDiagnosisPresentOnAdmission ( "Severe Maternal Morbidity Diagnoses", "Present on Admission is No or Unable To Determine" )
          )
            union "Delivery Encounters With Cardiac Conversion, Tracheostomy Or Ventilation Procedures"
            union "Delivery Encounters With Expiration"
        )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Numerator Exclusions 1":
      "SOC With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions":
      "Delivery Encounters With Severe Obstetric Complications Diagnosis Or Procedure Excluding Blood Transfusion"
        union "Delivery Encounters With Expiration"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions Only":
      "Delivery Encounters With Severe Obstetric Complications"
        intersect "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SOC Excluding Blood Transfusions Only With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
          where ( SOCExcludingTransfusion.reasonCode in "Placenta Increta or Percreta"
              or SOCExcludingTransfusion.encounterDiagnosis ( ).code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters With Blood Transfusion"
                or exists "Delivery Encounters With Hysterectomy"
            )
      )

    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy

        except ( ( "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
              where SOCExcludingTransfusion.isDiagnosisPresentOnAdmission ( "Severe Maternal Morbidity Diagnoses", "Present on Admission is No or Unable To Determine" )
          )
            union "Delivery Encounters With Cardiac Conversion, Tracheostomy Or Ventilation Procedures"
            union "Delivery Encounters With Expiration"
        )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Numerator Exclusions 2":
      "SOC Excluding Blood Transfusions Only With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Placental Accreta Spectrum":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Placenta Accreta", "Present On Admission is Yes or Exempt" )
          or TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Placenta Increta or Percreta", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Hypertension":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Hypertension", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Preterm Birth":
      ( PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
          let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
          EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
          where CGA in Interval[20, 36]
            or ( CGA is null
                and ( EGA >= 20 weeks
                    and EGA <= 36 weeks
                )
            )
      )
        union ( PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
            let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
            EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
            where CGA is null
              and EGA is null
              and exists ( ( DeliveryEncounter.claimDiagnosis ( ) ) CDiagnosis
                  where CDiagnosis.onAdmission ~ "POA-Y"
              )
        )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Placental Abruption":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Placental Abruption", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Morbid Obesity":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Morbid or Severe Obesity", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Preexisting Diabetes":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Preexisting Diabetes", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Bariatric Surgery":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Bariatric Surgery", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Placenta Previa":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Placenta Previa", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Bleeding Disorder":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Bleeding Disorder", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report white blood cell count as 10*3/uL

    define "Risk Variable First White Blood Cell Count Lab Test":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstWBC: First(["LaboratoryResultObservation": "White Blood Cells Count Lab Test"] WBC
            where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and WBC.status in { 'final', 'amended', 'corrected' }
              and WBC.value is not null
            sort by issued.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstWBCResult: FirstWBC.value as Quantity,
          Timing: FirstWBC.issued
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report hematocrit as %

    define "Risk Variable First Hematocrit Lab Test":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstHematocrit: First(["LaboratoryResultObservation": "Hematocrit Lab Test"] Hematocrit
            where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and Hematocrit.status in { 'final', 'amended', 'corrected' }
              and Hematocrit.value is not null
            sort by issued.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstHematocritResult: FirstHematocrit.value as Quantity,
          Timing: FirstHematocrit.issued
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Anemia":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Anemia", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Severe Preeclampsia":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Severe Preeclampsia", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Cardiac Disease":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Cardiac Disease", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Long Term Anticoagulant Use":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Long Term Anticoagulant Use", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    //First resulted value 24 hours prior to start of encounter and before time of delivery
    //Report systolic blood pressure as mm[Hg]
    //Systolic blood pressure value cannot be null per QICore profile requirement.

    define "Risk Variable Systolic Blood Pressure":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstSystolicBP: First(["USCoreBloodPressureProfile"] BP
            where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and BP.status in { 'final', 'amended', 'corrected' }
              and BP.component.value is not null
            sort by effective.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstSBPResult: singleton from ( FirstSystolicBP.component C
              where C.code ~ "Systolic blood pressure"
              return C.value as Quantity
          ),
          Timing: FirstSystolicBP.effective.earliest ( )
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Delivery Encounters With Severe Obstetric Complication Diagnosis":
      ( "Delivery Encounters With Severe Obstetric Complications"
        except "SOC With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC" ) Encounter
        where Encounter.isDiagnosisPresentOnAdmission ( "Severe Maternal Morbidity Diagnoses", "Present on Admission is No or Unable To Determine" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE SOC Diagnoses Detail":
      "SDE Delivery Encounters With Severe Obstetric Complication Diagnosis" Encounter
        let complication: Encounter.pOAIsNoOrUTD ( )
        return {
          id: Encounter.id,
          code: Encounter.type,
          complications: complication Complication
            where Complication in "Severe Maternal Morbidity Diagnoses"
              or Complication.getCondition ( ).code in "Severe Maternal Morbidity Diagnoses"
            return {
              code: Complication,
              SOCDxCategory: Complication.sOCDxCategory ( )
            }
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Substance Abuse":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Substance Abuse", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Renal Disease":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Renal Disease", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    //The next definition establishes a variable of CGA (Calculated Gestational Age).  CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function.  The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.

    define "SDE Variable Calculated Gestational Age":
      PCMaternal."Variable Calculated Gestational Age"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Gastrointestinal Disease":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Gastrointestinal Disease", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Pulmonary Hypertension":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Pulmonary Hypertension", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Delivery Encounters With Severe Obstetric Complication Procedures":
      ( "Delivery Encounters With Severe Obstetric Complications"
        except "SOC With Hysterectomy Or Blood Transfusion With Placenta Increta Or Placenta Percreta Without Additional SOC" ) Encounter
        where exists ( ["Procedure": "Severe Maternal Morbidity Procedures"]
          union ["Procedure": "Blood Transfusion"] ) SMMProcedures
          where SMMProcedures.status = 'completed'
            and SMMProcedures.performed.toInterval ( ) starts during Encounter.hospitalizationWithEDOBTriageObservation ( )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Other Preeclampsia":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Mild or Moderate Preeclampsia", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Thyrotoxicosis":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Thyrotoxicosis", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Initial Population":
      PCMaternal."Delivery Encounter With Age Range"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Neuromuscular Disease":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Neuromuscular Disease", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Economic Housing Instability":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Economic Housing Instability", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable HIV":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "HIV in Pregnancy Childbirth and Puerperium", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Maternal Age":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)
        return { TwentyWeeksPlusEncounter, MaternalAge }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report heart rate as beats/min
     //Heart rate value cannot be null per QICore profile requirement.

    define "Risk Variable Heart Rate":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstHeartRate: First([USCoreHeartRateProfile] HeartRate
            where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and HeartRate.status in { 'final', 'amended', 'corrected' }
            sort by effective.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstHRResult: FirstHeartRate.value as Quantity,
          Timing: FirstHeartRate.effective.earliest ( )
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Mental Health Disorder":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Mental Health Disorder", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Obstetrical VTE":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Venous Thromboembolism in Pregnancy", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Numerator 1":
      "Delivery Encounters With Severe Obstetric Complications"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Numerator 2":
      "Delivery Encounters With Severe Obstetric Complications Excluding Blood Transfusions Only"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Autoimmune Disease":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Autoimmune Disease", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Previous Cesarean":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Previous Cesarean", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Gestational Diabetes":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Gestational Diabetes", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE SOC Procedure Detail":
      "SDE Delivery Encounters With Severe Obstetric Complication Procedures" Encounter
        let procedure: Encounter.sOCProcedures ( )
        return {
          id: Encounter.id,
          code: Encounter.type,
          procedures: procedure P
            return {
              code: P,
              SOCProcedureCategory: P.sOCProcedureCategory ( )
            }
        }
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Risk Variable Multiple Pregnancy":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.isDiagnosisPresentOnAdmission ( "Multiple Pregnancy", "Present On Admission is Yes or Exempt" )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "Denominator":
      "Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define fluent function pOAIsNoOrUTD(TheEncounter Encounter):
      ( TheEncounter.claimDiagnosis ( ) ) CDiagnoses
        where CDiagnoses.onAdmission in "Present on Admission is No or Unable To Determine"
        return CDiagnoses.diagnosis
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define fluent function sOCDxCategory(Dx Concept):
      case
        when Dx in "Acute Heart Failure" then 'Acute Heart Failure'
        when Dx in "Acute Myocardial Infarction" then 'Acute Myocardial Infarction'
        when Dx in "Acute Renal Failure" then 'Acute Renal Failure'
        when Dx in "Acute Respiratory Distress Syndrome" then 'Acute Respiratory Distress Syndrome'
        when Dx in "Air and Thrombotic Embolism" then 'Air and Thrombotic Embolism'
        when Dx in "Amniotic Fluid Embolism" then 'Amniotic Fluid Embolism'
        when Dx in "Aortic Aneurysm" then 'Aortic Aneurysm'
        when Dx in "Cardiac Arrest Ventricular Fibrillation" then 'Cardiac Arrest Ventricular Fibrillation'
        when Dx in "Disseminated Intravascular Coagulation" then 'Disseminated Intravascular Coagulation'
        when Dx in "Eclampsia" then 'Eclampsia'
        when Dx in "Heart Failure Cardiac Arrest Related to Procedure or Surgery" then 'Heart Failure Cardiac Arrest Related to Procedure or Surgery'
        when Dx in "Puerperal Cerebrovascular Disorder" then 'Puerperal Cerebrovascular Disorder'
        when Dx in "Pulmonary Edema" then 'Pulmonary Edema'
        when Dx in "Sepsis" then 'Sepsis'
        when Dx in "Severe Anesthesia Complications" then 'Severe Anesthesia Complications'
        when Dx in "Shock" then 'Shock'
        when Dx in "Sickle Cell Disease with Crisis" then 'Sickle Cell Disease with Crisis'
        else null end
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define fluent function sOCProcedures(TheEncounter Encounter):
      ( ["Procedure": "Severe Maternal Morbidity Procedures"]
        union ["Procedure": "Blood Transfusion"] ) SMMProcedures
        where SMMProcedures.status = 'completed'
          and SMMProcedures.performed.toInterval ( ) starts during TheEncounter.hospitalizationWithEDOBTriageObservation ( )
Logic Definition | Library Name: CMS1028FHIRPCSevereOBComps
    define fluent function sOCProcedureCategory(TheProcedure Procedure):
      case
        when TheProcedure.code in "Blood Transfusion" then 'Blood Transfusion'
        when TheProcedure.code in "Conversion of Cardiac Rhythm" then 'Conversion of cardiac rhythm'
        when TheProcedure.code in "Hysterectomy" then 'Hysterectomy'
        when TheProcedure.code in "Tracheostomy" then 'Tracheostomy'
        when TheProcedure.code in "Ventilation" then 'Ventilation'
        else null end
Terminology
Code System | Description: Code system LOINC Resource: http://loinc.org Canonical URL: `http://loinc.org`
Code System | Description: Code system Present On Admission Indicators Resource: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding Canonical URL: `https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding`
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
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 Delivery Procedures Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59`
Value Set | Description: Value set Observation Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143`
Value Set | Description: Value set ED Visit and OB Triage Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369`
Value Set | Description: Value set Estimated Gestational Age at Delivery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26`
Value Set | Description: Value set 20 to 42 Plus Weeks Gestation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67`
Value Set | Description: Value set Acute or Persistent Asthma Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.271 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.271`
Value Set | Description: Value set Present On Admission is Yes or Exempt Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63`
Value Set | Description: Value set Severe Maternal Morbidity Diagnoses Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255`
Value Set | Description: Value set Present on Admission is No or Unable To Determine Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370`
Value Set | Description: Value set Severe Maternal Morbidity Procedures Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256`
Value Set | Description: Value set Patient Expired Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309`
Value Set | Description: Value set Blood Transfusion Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213`
Value Set | Description: Value set Placenta Increta or Percreta Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388`
Value Set | Description: Value set Hysterectomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358`
Value Set | Description: Value set Conversion of Cardiac Rhythm Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357`
Value Set | Description: Value set Tracheostomy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359`
Value Set | Description: Value set Ventilation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360`
Value Set | Description: Value set Placenta Accreta Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302`
Value Set | Description: Value set Hypertension Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332`
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 Placental Abruption Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305`
Value Set | Description: Value set Morbid or Severe Obesity Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290`
Value Set | Description: Value set Preexisting Diabetes Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275`
Value Set | Description: Value set Bariatric Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317`
Value Set | Description: Value set Placenta Previa Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78`
Value Set | Description: Value set Bleeding Disorder Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287`
Value Set | Description: Value set White Blood Cells Count Lab Test Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129`
Value Set | Description: Value set Hematocrit Lab Test Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114`
Value Set | Description: Value set Anemia Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323`
Value Set | Description: Value set Severe Preeclampsia Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327`
Value Set | Description: Value set Cardiac Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341`
Value Set | Description: Value set Long Term Anticoagulant Use Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366`
Value Set | Description: Value set Acute Heart Failure Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.233 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.233`
Value Set | Description: Value set Acute Myocardial Infarction Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.623 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.623`
Value Set | Description: Value set Acute Renal Failure Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.53 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.53`
Value Set | Description: Value set Acute Respiratory Distress Syndrome Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.214 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.214`
Value Set | Description: Value set Air and Thrombotic Embolism Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.243 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.243`
Value Set | Description: Value set Amniotic Fluid Embolism Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.217 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.217`
Value Set | Description: Value set Aortic Aneurysm Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.219 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.219`
Value Set | Description: Value set Cardiac Arrest Ventricular Fibrillation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.221 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.221`
Value Set | Description: Value set Disseminated Intravascular Coagulation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.223 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.223`
Value Set | Description: Value set Eclampsia Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.225 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.225`
Value Set | Description: Value set Heart Failure Cardiac Arrest Related to Procedure or Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.227 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.227`
Value Set | Description: Value set Puerperal Cerebrovascular Disorder Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.229 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.229`
Value Set | Description: Value set Pulmonary Edema Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.231 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.231`
Value Set | Description: Value set Sepsis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.237 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.237`
Value Set | Description: Value set Severe Anesthesia Complications Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.235 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.235`
Value Set | Description: Value set Shock Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.239 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.239`
Value Set | Description: Value set Sickle Cell Disease with Crisis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.241 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.241`
Value Set | Description: Value set Substance Abuse Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320`
Value Set | Description: Value set Renal Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335`
Value Set | Description: Value set Gastrointestinal Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338`
Value Set | Description: Value set Pulmonary Hypertension Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281`
Value Set | Description: Value set Mild or Moderate Preeclampsia Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329`
Value Set | Description: Value set Thyrotoxicosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296`
Value Set | Description: Value set Neuromuscular Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308`
Value Set | Description: Value set Economic Housing Instability Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292`
Value Set | Description: Value set HIV in Pregnancy Childbirth and Puerperium Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272`
Value Set | Description: Value set Mental Health Disorder Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314`
Value Set | Description: Value set Venous Thromboembolism in Pregnancy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363`
Value Set | Description: Value set Autoimmune Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311`
Value Set | Description: Value set Previous Cesarean Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278`
Value Set | Description: Value set Gestational Diabetes Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269`
Value Set | Description: Value set Multiple Pregnancy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284`
Direct Reference Code | Display: Date and time of obstetric delivery Code: 93857-1 System: `http://loinc.org`
Direct Reference Code | Display: Delivery date Estimated Code: 11778-8 System: `http://loinc.org`
Direct Reference Code | Code: Y System: `https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding`
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: Systolic blood pressure Code: 8480-6 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 PCMaternal Resource: https://madie.cms.gov/Library/PCMaternal|5.25.000 Canonical URL: `https://madie.cms.gov/Library/PCMaternal|5.25.000`
Dependency | Description: Library CQMCommon Resource: https://madie.cms.gov/Library/CQMCommon|4.1.000 Canonical URL: `https://madie.cms.gov/Library/CQMCommon|4.1.000`
Dependency | Description: Library FHIRHelpers Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 Canonical URL: `https://madie.cms.gov/Library/FHIRHelpers|4.4.000`
Dependency | Description: Library QICoreCommon Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000 Canonical URL: `https://madie.cms.gov/Library/QICoreCommon|4.0.000`
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`
Data Requirements
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, reasonCode, onAdmission, diagnosis, diagnosis.code, hospitalization, hospitalization.dischargeDisposition, id, id.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value, reasonCode, onAdmission, diagnosis, diagnosis.code, hospitalization, hospitalization.dischargeDisposition, id, id.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period, reasonCode, onAdmission, diagnosis, diagnosis.code, hospitalization, hospitalization.dischargeDisposition, id, id.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: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: birthDate, birthDate.value, url, extension
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: code, value, status, status.value, effective Code Filter(s): Path: code Code(s): http://loinc.org#93857-1: 'Date and time of obstetric delivery'
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: code, value, status, status.value, effective Code Filter(s): Path: code Code(s): http://loinc.org#11778-8: 'Delivery date Estimated'
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: code, effective, value, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: value
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Data Requirement | Type: Resource Profile(s): http://hl7.org/fhir/StructureDefinition/Resource Must Support Elements: id, id.value
Data Requirement | Type: Claim Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim Must Support Elements: status, status.value, use, use.value, item
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-lab Must Support Elements: code, issued, issued.value, status, status.value, value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab Must Support Elements: code, issued, issued.value, status, status.value, value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure Must Support Elements: effective, status, status.value, component
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate Must Support Elements: effective, status, status.value, value
Generated using version 0.4.8 of the sample-content-ig Liquid templates