Quality Measure Implementation Guide (STU5)
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This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0-ballot2: STU5 (v5.0.0) Ballot 2) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions

: Module Definition Library - EXM125 - XML Representation

Active as of 2022-02-22

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<Library xmlns="http://hl7.org/fhir">
  <id value="effective-data-requirements-exm125"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <table class="grid dict">
        
        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">Module Definition Library - EXM125</td>
        </tr>
        

        
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">effective-data-requirements-exm125</td>
        </tr>
        

        
        
        <tr>
            <th scope="row"><b>Version: </b></th>
            <td style="padding-left: 4px;">1.0.0</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="Library-effective-data-requirements-exm125.html">Module Definition Library - EXM125</a></td>
        </tr>
        

        

        

        

        

        
        <tr>
            <th scope="row"><b>Type: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-library-type.html">LibraryType</a></span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>module-definition</span>
                        </p>
                        
                        
                    
                
                
            </td>
        </tr>
        

        

        
        <tr>
            <th scope="row"><b>Date: </b></th>
            <td style="padding-left: 4px;">2022-02-22 10:37:03-0700</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Publisher: </b></th>
            <td style="padding-left: 4px;">HL7 International / Clinical Quality Information</td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Description: </b></th>
            <td style="padding-left: 4px;"><div><p>This library is used as an example module definition in the FHIR Quality Measure Implementation Guide</p>
</div></td>
        </tr>
        

        

        

        

        
        <tr>
            <th scope="row"><b>Jurisdiction: </b></th>
            <td style="padding-left: 4px;">US</td>
        </tr>
        

        

        

        

        

        

        

        

        
        <tr>
            <th scope="row"><b>Related Artifacts: </b></th>
            <td style="padding-left: 4px;">
                
                
                
                <p><b>Dependencies</b></p>
                <ul>
                  
                    <li><a href="Library-SupplementalDataElements.html">Supplemental Data Elements Library</a></li>
                  
                    <li><a href="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>
                  
                    <li><a href="Library-MATGlobalCommonFunctions.html">MAT Global Common Functions FHIR Library</a></li>
                  
                    <li><a href="Library-AdultOutpatientEncounters.html">Adult Outpatient Encounters Common Library</a></li>
                  
                    <li><a href="Library-Hospice.html">Hospice FHIR Library</a></li>
                  
                    <li><a href="http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709">http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</a></li>
                  
                    <li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1018/expansion">Mammography</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services Established Office Visit, 18 and Up</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services Initial Office Visit, 18 and Up</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1020/expansion">Unilateral Mastectomy</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1070/expansion">Status Post Right Mastectomy</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1071/expansion">Unilateral Mastectomy, Unspecified Laterality</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.122.12.1035/expansion">Right</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1069/expansion">Status Post Left Mastectomy</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.122.12.1036/expansion">Left</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1068/expansion">History of bilateral mastectomy</a></li>
                  
                    <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1005/expansion">Bilateral Mastectomy</a></li>
                  
                </ul>
                
                
                
                
                
            </td>
        </tr>
        

        
        <tr>
          <th scope="row"><b>Parameters: </b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              <tr><th><b>Name</b></th><th><b>Type</b></th><th><b>Min</b></th><th><b>Max</b></th><th><b>In/Out</b></th></tr>
              
                <tr><th>Measurement Period</th><th>Period</th><th>0</th><th>1</th><th>in</th></tr>
              
                <tr><th>SDE Sex</th><th>Coding</th><th>0</th><th>1</th><th>out</th></tr>
              
                <tr><th>Numerator</th><th>boolean</th><th>0</th><th>1</th><th>out</th></tr>
              
                <tr><th>Denominator</th><th>boolean</th><th>0</th><th>1</th><th>out</th></tr>
              
                <tr><th>SDE Payer</th><th>Resource</th><th>0</th><th>*</th><th>out</th></tr>
              
                <tr><th>Initial Population</th><th>boolean</th><th>0</th><th>1</th><th>out</th></tr>
              
                <tr><th>SDE Ethnicity</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>
              
                <tr><th>Denominator Exclusion</th><th>boolean</th><th>0</th><th>1</th><th>out</th></tr>
              
                <tr><th>SDE Race</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>
              
            </table>
          </td>
        </tr>
        

        
        <tr>
          <th scope="row"><b>Data Requirements:</b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              <tr><th><b>Type</b></th><th><b>Profile</b></th><th><b>MS</b></th><th><b>Code Filter</b></th></tr>
              
                <tr>
                  <th>Coverage</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Coverage</th>
                  <th>;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Patient</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Patient</th>
                  <th>;;;</th>
                  <th>
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Condition</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Condition</th>
                  <th>;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Condition</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Condition</th>
                  <th>;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Condition</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Condition</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Condition</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Condition</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Procedure</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Procedure</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Procedure</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Procedure</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Procedure</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Procedure</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>Encounter</th>
                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>
                  <th>;;;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>type</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>ServiceRequest</th>
                  <th>http://hl7.org/fhir/StructureDefinition/ServiceRequest</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
                <tr>
                  <th>DiagnosticReport</th>
                  <th>http://hl7.org/fhir/StructureDefinition/DiagnosticReport</th>
                  <th>;;;</th>
                  <th>
                    
                      <b>code filter: </b>
                      
                      <br/>
                      
                      
                      <span style="padding-left: 4px;">
                          <b>path: </b><span>code</span>
                      </span>
                      
                      <br/>
                      
                      
                      
                      <span style="padding-left: 4px;">
                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018</span>
                      </span>
                      
                      
                    
                  </th>
                </tr>
              
            </table>
          </td>
        </tr>
        

        
    </table>
</div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
    <valueCoding>
      <system value="http://snomed.info/sct"/>
      <version value="http://snomed.info/sct/731000124108/version/201709"/>
      <code value="428361000124107"/>
      <display value="Discharge to home for hospice care (procedure)"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
    <valueCoding>
      <system value="http://snomed.info/sct"/>
      <version value="http://snomed.info/sct/731000124108/version/201709"/>
      <code value="428371000124100"/>
      <display
               value="Discharge to healthcare facility for hospice care (procedure)"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
    <valueCoding>
      <system
              value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
      <code value="active"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="SupplementalDataElements"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Sex"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Sex&quot;:
  case
      when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
      when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
      else null
    end"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="0"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Sex"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="1"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Numerator"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Numerator&quot;:
		exists (
				[DiagnosticReport: &quot;Mammography&quot;] Mammogram
						where ( Global.&quot;Normalize Interval&quot;(Mammogram.effective) ends 27 months or less before day of end of &quot;Measurement Period&quot; )
								and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }
		)"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="2"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="AdultOutpatientEncounters"/>
    </extension>
    <extension url="name">
      <valueString value="Qualifying Encounters"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Qualifying Encounters&quot;:
	(
    [Encounter: &quot;Office Visit&quot;]
  		union [Encounter: &quot;Annual Wellness Visit&quot;]
  		union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]
  		union [Encounter: &quot;Home Healthcare Services&quot;]
  ) ValidEncounter
		where ValidEncounter.period during &quot;Measurement Period&quot;
  		and ValidEncounter.status  = 'finished'"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="3"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Initial Population"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Initial Population&quot;:
		Patient.gender = 'female'
				and Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[51, 74]
				and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="4"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Denominator"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Denominator&quot;:
		&quot;Initial Population&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="5"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="SupplementalDataElements"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Payer"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="6"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Payer"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="7"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="SupplementalDataElements"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Ethnicity"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Ethnicity&quot;:
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="8"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Ethnicity"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="9"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="Hospice"/>
    </extension>
    <extension url="name">
      <valueString value="Has Hospice"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Has Hospice&quot;:
	exists (
    [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice
			where DischargeHospice.status = 'finished'
		    and (
	        DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
				    or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
	    	)
				and DischargeHospice.period ends during &quot;Measurement Period&quot;
	)
    or exists (
      [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder
        where HospiceOrder.intent = 'order'
            and HospiceOrder.authoredOn in &quot;Measurement Period&quot;
    )
    or exists (
      [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed
        where HospicePerformed.status = 'completed'
          and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&quot;
    )"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="10"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Unilateral Mastectomy Procedure"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Unilateral Mastectomy Procedure&quot;:
		[Procedure: &quot;Unilateral Mastectomy&quot;] UnilateralMastectomyProcedure
				where Global.&quot;Normalize Interval&quot;(UnilateralMastectomyProcedure.performed) ends before day of end of &quot;Measurement Period&quot;
						and UnilateralMastectomyProcedure.status = 'completed'"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="11"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Right Mastectomy"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Right Mastectomy&quot;:
		(
				( [Condition: &quot;Status Post Right Mastectomy&quot;] C
          where C.clinicalStatus ~ ToConcept(Global.&quot;active&quot;)
        )
				union (
						[Condition: &quot;Unilateral Mastectomy, Unspecified Laterality&quot;] UnilateralMastectomyDiagnosis
								where UnilateralMastectomyDiagnosis.bodySite in &quot;Right&quot;
                  and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global.&quot;active&quot;)
				)
		) RightMastectomy
				where Global.&quot;Normalize Interval&quot;(RightMastectomy.onset) starts before day of end of &quot;Measurement Period&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="12"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Left Mastectomy"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Left Mastectomy&quot;:
		(
		    ( [Condition: &quot;Status Post Left Mastectomy&quot;] C
          where C.clinicalStatus ~ ToConcept(Global.&quot;active&quot;)
        )
				union (
						[Condition: &quot;Unilateral Mastectomy, Unspecified Laterality&quot;] UnilateralMastectomyDiagnosis
								where UnilateralMastectomyDiagnosis.bodySite in &quot;Left&quot;
                  and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global.&quot;active&quot;)
				)
		) LeftMastectomy
				where Global.&quot;Normalize Interval&quot;(LeftMastectomy.onset) starts before day of end of &quot;Measurement Period&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="13"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="History Bilateral Mastectomy"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;History Bilateral Mastectomy&quot;:
		[Condition: &quot;History of bilateral mastectomy&quot;] BilateralMastectomyHistory
				where Global.&quot;Normalize Interval&quot;(BilateralMastectomyHistory.onset) starts before day of end of &quot;Measurement Period&quot;
          and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global.&quot;active&quot;)"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="14"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Bilateral Mastectomy Procedure"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Bilateral Mastectomy Procedure&quot;:
		[Procedure: &quot;Bilateral Mastectomy&quot;] BilateralMastectomyPerformed
				where Global.&quot;Normalize Interval&quot;(BilateralMastectomyPerformed.performed) ends before day of end of &quot;Measurement Period&quot;
						and BilateralMastectomyPerformed.status = 'completed'"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="15"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="Denominator Exclusion"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Denominator Exclusion&quot;:
		Hospice.&quot;Has Hospice&quot;
				or ( Count(&quot;Unilateral Mastectomy Procedure&quot;) = 2 )
				or ( exists &quot;Right Mastectomy&quot; and exists &quot;Left Mastectomy&quot; )
				or exists &quot;History Bilateral Mastectomy&quot;
				or exists &quot;Bilateral Mastectomy Procedure&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="16"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="SupplementalDataElements"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Race"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Race&quot;:
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="17"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXM125-FHIR"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Race"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="18"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cqi"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/cqfmeasures/Library/effective-data-requirements-exm125"/>
  <version value="1.0.0"/>
  <name value="EffectiveDataRequirements"/>
  <title value="Module Definition Library - EXM125"/>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
      <code value="module-definition"/>
    </coding>
  </type>
  <date value="2022-02-22T10:37:03-07:00"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="This library is used as an example module definition in the FHIR Quality Measure Implementation Guide"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library SDE"/>
    <resource
              value="http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library FHIRHelpers"/>
    <resource
              value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library Global"/>
    <resource
              value="http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library AdultOutpatientEncounters"/>
    <resource
              value="http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library Hospice"/>
    <resource
              value="http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Code system SNOMEDCT:2017-09"/>
    <resource
              value="http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Code system ConditionClinicalStatusCodes"/>
    <resource
              value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Mammography"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Office Visit"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Annual Wellness Visit"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display
             value="Value set Preventive Care Services - Established Office Visit, 18 and Up"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display
             value="Value set Preventive Care Services-Initial Office Visit, 18 and Up"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Home Healthcare Services"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Payer"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Encounter Inpatient"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Hospice care ambulatory"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Unilateral Mastectomy"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Status Post Right Mastectomy"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Unilateral Mastectomy, Unspecified Laterality"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Right"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Status Post Left Mastectomy"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Left"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set History of bilateral mastectomy"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Bilateral Mastectomy"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"/>
  </relatedArtifact>
  <parameter>
    <name value="Measurement Period"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <type value="Period"/>
  </parameter>
  <parameter>
    <name value="SDE Sex"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <type value="Coding"/>
  </parameter>
  <parameter>
    <name value="Numerator"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <type value="boolean"/>
  </parameter>
  <parameter>
    <name value="Denominator"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <type value="boolean"/>
  </parameter>
  <parameter>
    <name value="SDE Payer"/>
    <use value="out"/>
    <min value="0"/>
    <max value="*"/>
    <type value="Resource"/>
  </parameter>
  <parameter>
    <name value="Initial Population"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <type value="boolean"/>
  </parameter>
  <parameter>
    <name value="SDE Ethnicity"/>
    <use value="out"/>
    <min value="0"/>
    <max value="*"/>
    <type value="Coding"/>
  </parameter>
  <parameter>
    <name value="Denominator Exclusion"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <type value="boolean"/>
  </parameter>
  <parameter>
    <name value="SDE Race"/>
    <use value="out"/>
    <min value="0"/>
    <max value="*"/>
    <type value="Coding"/>
  </parameter>
  <dataRequirement>
    <type value="Coverage"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
    <mustSupport value="period"/>
    <mustSupport value="type"/>
    <codeFilter>
      <path value="type"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Patient"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
    <mustSupport value="extension"/>
    <mustSupport value="value"/>
    <mustSupport value="url"/>
  </dataRequirement>
  <dataRequirement>
    <type value="Condition"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
    <mustSupport value="code"/>
    <mustSupport value="clinicalStatus"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Condition"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
    <mustSupport value="code"/>
    <mustSupport value="clinicalStatus"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Condition"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
    <mustSupport value="bodySite"/>
    <mustSupport value="code"/>
    <mustSupport value="clinicalStatus"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Condition"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
    <mustSupport value="code"/>
    <mustSupport value="clinicalStatus"/>
    <mustSupport value="onset"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Procedure"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
    <mustSupport value="code"/>
    <mustSupport value="performed"/>
    <mustSupport value="status"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
                value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"/>
    </codeFilter>
  </dataRequirement>
  <dataRequirement>
    <type value="Procedure"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
    <mustSupport value="code"/>
    <mustSupport value="performed"/>
    <mustSupport value="status"/>
    <codeFilter>
      <path value="code"/>
      <valueSet
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