Quality Measure Implementation Guide
1.0.0-ballot - ballot International flag

This page is part of the Quality Measure Implementation Guide (v1.0.0-ballot: STU1 (v1.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

: EXM130 - Colorectal Cancer Screening Measure - XML Representation

Active as of 2022-02-22

Raw xml | Download


<Measure xmlns="http://hl7.org/fhir">
  <id value="EXM130-FHIR"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure"/>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"/>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
<div>
    <table class="grid dict">
        
            <tr>
                <th scope="row"><b>Title: </b></th>
                <td style="padding-left: 4px;">EXM130 - Colorectal Cancer Screening Measure</td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Id: </b></th>
                <td style="padding-left: 4px;">EXM130-FHIR</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Version: </b></th>
                <td style="padding-left: 4px;">8.0.000</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Url: </b></th>
                <td style="padding-left: 4px;"><a href="Measure-EXM130-FHIR.html">EXM130 - Colorectal Cancer Screening Measure</a></td>
            </tr>
        

        
            <tr>
                <th scope="row">
                    <b>
                        
                            Official
                        
                    </b>
                </th>

                <td style="padding-left: 4px;">
                    
                        <p style="margin-bottom: 5px;">
                            <span>130</span>
                        </p>
                    
                </td>
            </tr>
        
            <tr>
                <th scope="row">
                    <b>
                        
                            Official
                        
                    </b>
                </th>

                <td style="padding-left: 4px;">
                    
                        <p style="margin-bottom: 5px;">
                            <span>0034</span>
                        </p>
                    
                </td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Effective Period: </b></th>
                <td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Experimental: </b></th>
                <td style="padding-left: 4px;">true</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>Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer</p>
</div></td>
            </tr>
        

        

        

        
            <tr>
                <th scope="row"><b>Use Context: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        <tr>
                            <th><b>code</b></th>
                            <th><b>value</b></th>
                        </tr>
                        
                            <tr>
                                <td>venue</td>
                                <td/>
                            </tr>
                        
                    </table>
                </td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Jurisdiction: </b></th>
                <td style="padding-left: 4px;">001</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Topic: </b></th>
                <td style="padding-left: 4px;">57024-2</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Purpose: </b></th>
                <td style="padding-left: 4px;"><div><p>This measure has been developed to support improvement in clinical care.</p>
</div></td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Copyright: </b></th>
                <td style="padding-left: 4px;"><div><p>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.</p>
</div></td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Disclaimer: </b></th>
                <td style="padding-left: 4px;"><div><p>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
            </tr>
        

        

        

        
            <tr>
                <th scope="row"><b>Scoring: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>Proportion </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Type: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>process </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        

        
        <tr>
            <th scope="row"><b>Rationale: </b></th>
            <td style="padding-left: 4px;"><div><p>Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017).</p>
</div></td>
        </tr>
        

        
        <tr>
            <th scope="row"><b>Clinical recommendation statement: </b></th>
            <td style="padding-left: 4px;"><div><p>The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)</p>
</div></td>
        </tr>
        

        
            <tr>
                <th scope="row"><b>Improvement Notation: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>Increased score indicates improvement </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        
            
        

        
            <tr>
                <th scope="row"><b> Supplemental Data Elements: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            
                                
                                    <p>SDE Ethnicity</p>
                                
                            
                        
                    
                        
                            
                                
                                    <p>SDE Payer</p>
                                
                            
                        
                    
                        
                            
                                
                                    <p>SDE Race</p>
                                
                            
                        
                    
                        
                            
                                
                                    <p>SDE Sex</p>
                                
                            
                        
                    
                </td>
            </tr>
        

        

        

        
            <tr>
                <th scope="row"><b>Libraries: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        
                            <tr>
                                <td><a href="Library-EXM130-FHIR.html">EXM130 - Colorectal Cancer Screening Library</a></td>
                            </tr>
                        
                    </table>
                </td>
            </tr>
        

        

        
            
                <tr>
                    <th scope="row"><b>Terminology and Other Dependencies: </b></th>
                    <td style="padding-left: 4px;">
                        
                            <li><a href="Library-SupplementalDataElements.html">Supplemental Data Elements Libraryversion: null2.0.0)</a></li>
                        
                            <li><code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code></li>
                        
                            <li><a href="Library-MATGlobalCommonFunctions.html">MAT Global Common Functions FHIR Libraryversion: null5.0.000)</a></li>
                        
                            <li><a href="Library-AdultOutpatientEncounters.html">Adult Outpatient Encounters Common Libraryversion: null2.0.000)</a></li>
                        
                            <li><a href="Library-Hospice.html">Hospice FHIR Libraryversion: null2.0.000)</a></li>
                        
                            <li><code>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code></li>
                        
                    </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>use</b></th>
                                <th><b>min</b></th>
                                <th><b>max</b></th>
                                <th><b>type</b></th>
                            </tr>
                            
                                <tr>
                                    <td>Measurement Period</td>
                                    <td>In</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>Period</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Sex</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>Coding</td>
                                </tr>
                            
                                <tr>
                                    <td>Numerator</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Payer</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Resource</td>
                                </tr>
                            
                                <tr>
                                    <td>Initial Population</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Ethnicity</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Coding</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator Exclusion</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Race</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Coding</td>
                                </tr>
                            
                        </table>
                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>DataRequirements:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <tr>
                                <th><b>Resource Type</b></th>
                                <th><b>Resource Elements</b></th>
                                <th><b>Valueset Name</b></th>
                                <th><b>Valueset</b></th>
                            </tr>
                            
                                <tr>
                                    <td>Coverage(<a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a>)</td>
                                    <td>
                                        
                                            period
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Payer
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Patient(<a href="http://hl7.org/fhir/R4/patient.html">Patient</a>)</td>
                                    <td>
                                        
                                            extension
                                        
                                            value
                                        
                                            url
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td/>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Office Visit
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Annual Wellness Visit
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Preventive Care Services - Established Office Visit, 18 and Up
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Preventive Care Services-Initial Office Visit, 18 and Up
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Home Healthcare Services
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            period
                                        
                                            hospitalization
                                        
                                            hospitalization.dischargeDisposition
                                        
                                            type
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Encounter Inpatient
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Condition(<a href="http://hl7.org/fhir/R4/condition.html">Condition</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            onset
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Malignant Neoplasm of Colon
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Observation(<a href="http://hl7.org/fhir/R4/observation.html">Observation</a>)</td>
                                    <td>
                                        
                                            effective
                                        
                                            code
                                        
                                            value
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 FIT DNA
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Observation(<a href="http://hl7.org/fhir/R4/observation.html">Observation</a>)</td>
                                    <td>
                                        
                                            effective
                                        
                                            code
                                        
                                            value
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Fecal Occult Blood Test (FOBT)
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Colonoscopy
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Total Colectomy
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 CT Colonography
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Hospice care ambulatory
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Flexible Sigmoidoscopy
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code></td>
                                </tr>
                            
                                <tr>
                                    <td>ServiceRequest(<a href="http://hl7.org/fhir/R4/servicerequest.html">ServiceRequest</a>)</td>
                                    <td>
                                        
                                            code
                                        
                                            authoredOn
                                        
                                            intent
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Hospice care ambulatory
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></td>
                                </tr>
                            
                        </table>
                    </td>
                </tr>

                

                
                    <tr>
                        <th scope="row"><b>Direct Reference Codes:</b></th>
                        <td style="padding-left: 4px;">
                            <table class="grid-dict">
                                <tr>
                                    <th><b>display</b></th>
                                    <th><b>code</b></th>
                                    <th><b>system</b></th>
                                </tr>
                                
                                    <tr>
                                        <td>Discharge to home for hospice care (procedure)</td>
                                        <td>428361000124107</td>
                                        <td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
                                    </tr>
                                
                                    <tr>
                                        <td>Discharge to healthcare facility for hospice care (procedure)</td>
                                        <td>428371000124100</td>
                                        <td><a href="https://browser.ihtsdotools.org/">http://snomed.info/sct</a></td>
                                    </tr>
                                
                            </table>
                        </td>
                    </tr>
                

                
                <tr>
                    <th scope="row"><b>Logic Definitions:</b></th>
                    <td style="padding-left: 4px;">
                        
                        <table class="grid-dict">
                            <tr>
                                <th><b>Group</b></th>
                                <th><b>Scoring</b></th>
                                <th><b>Population Criteria</b></th>
                                <th><b>Expression</b></th>
                            </tr>
                            <tr>
                                
                                <td>  </td>
                                <td colspan="3" style="padding-left: 4px;">
                                    

                                    

                                    
                                        <b>Measure scoring:</b>
                                        
                                            <p style="margin-bottom: 5px;">
                                                <span>Proportion</span>
                                            </p>
                                        
                                    

                                    

                                    

                                    

                                    

                                    

                                    

                                </td>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Initial Population</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Initial Population&quot;:
	Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[50, 75]
			and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Numerator</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Numerator&quot;:
	exists &quot;Colonoscopy Performed&quot;
		or exists &quot;Fecal Occult Blood Test Performed&quot;
		or exists &quot;Flexible Sigmoidoscopy Performed&quot;
		or exists &quot;Fecal Immunochemical Test DNA&quot;
		or exists &quot;CT Colonography Performed&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Denominator</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Denominator&quot;:
	true</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Denominator Exclusion</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Denominator Exclusion&quot;:
	Hospice.&quot;Has Hospice&quot;
		or exists &quot;Malignant Neoplasm Ever&quot;
		or exists &quot;Total Colectomy Performed&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                
                            
                            </tr>
                        </table>
                

                <table class="grid-dict">
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>SupplementalDataElements</td>
                            
                            
                                <td>SDE Sex</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">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</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>SDE Sex</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Colonoscopy Performed</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Colonoscopy Performed&quot;:
	[Procedure: &quot;Colonoscopy&quot;] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global.&quot;Normalize Interval&quot;(Colonoscopy.performed) ends 10 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Fecal Occult Blood Test Performed</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Fecal Occult Blood Test Performed&quot;:
	[Observation: &quot;Fecal Occult Blood Test (FOBT)&quot;] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global.&quot;Normalize Interval&quot;(FecalOccultResult.effective) during day of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Flexible Sigmoidoscopy Performed</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Flexible Sigmoidoscopy Performed&quot;:
	[Procedure: &quot;Flexible Sigmoidoscopy&quot;] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Fecal Immunochemical Test DNA</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Fecal Immunochemical Test DNA&quot;:
	[Observation: &quot;FIT DNA&quot;] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global.&quot;Normalize Interval&quot;(FitDNA.effective) occurs 3 years or less on or before day of end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>CT Colonography Performed</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;CT Colonography Performed&quot;:
	[Procedure: &quot;CT Colonography&quot;] Colonography
		where Colonography.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colonography.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Numerator</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
	exists &quot;Colonoscopy Performed&quot;
		or exists &quot;Fecal Occult Blood Test Performed&quot;
		or exists &quot;Flexible Sigmoidoscopy Performed&quot;
		or exists &quot;Fecal Immunochemical Test DNA&quot;
		or exists &quot;CT Colonography Performed&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Denominator</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
	true</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>SupplementalDataElements</td>
                            
                            
                                <td>SDE Payer</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>SDE Payer</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>AdultOutpatientEncounters</td>
                            
                            
                                <td>Qualifying Encounters</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">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'</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Initial Population</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
	Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[50, 75]
			and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>SupplementalDataElements</td>
                            
                            
                                <td>SDE Ethnicity</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">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</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>SDE Ethnicity</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>Hospice</td>
                            
                            
                                <td>Has Hospice</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">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;
    )</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Malignant Neoplasm Ever</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Malignant Neoplasm Ever&quot;:
	[Condition: &quot;Malignant Neoplasm of Colon&quot;] ColorectalCancer
		where Global.&quot;Normalize Interval&quot;(ColorectalCancer.onset) starts on or before end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Total Colectomy Performed</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Total Colectomy Performed&quot;:
	[Procedure: &quot;Total Colectomy&quot;] Colectomy
		where Colectomy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colectomy.performed) starts on or before end of &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>Denominator Exclusion</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusion&quot;:
	Hospice.&quot;Has Hospice&quot;
		or exists &quot;Malignant Neoplasm Ever&quot;
		or exists &quot;Total Colectomy Performed&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>SupplementalDataElements</td>
                            
                            
                                <td>SDE Race</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">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</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM130-FHIR</td>
                            
                            
                                <td>SDE Race</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                    </table>
                </td>
            </tr>
            
        
    

    </table>
</div>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements-exm130"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"/>
      </meta>
      <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-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="EXM130-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="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Colonoscopy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Colonoscopy Performed&quot;:
	[Procedure: &quot;Colonoscopy&quot;] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global.&quot;Normalize Interval&quot;(Colonoscopy.performed) ends 10 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Fecal Occult Blood Test Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Fecal Occult Blood Test Performed&quot;:
	[Observation: &quot;Fecal Occult Blood Test (FOBT)&quot;] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global.&quot;Normalize Interval&quot;(FecalOccultResult.effective) during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Flexible Sigmoidoscopy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Flexible Sigmoidoscopy Performed&quot;:
	[Procedure: &quot;Flexible Sigmoidoscopy&quot;] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Fecal Immunochemical Test DNA"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Fecal Immunochemical Test DNA&quot;:
	[Observation: &quot;FIT DNA&quot;] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global.&quot;Normalize Interval&quot;(FitDNA.effective) occurs 3 years or less on or before day of end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="CT Colonography Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;CT Colonography Performed&quot;:
	[Procedure: &quot;CT Colonography&quot;] Colonography
		where Colonography.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colonography.performed) ends 5 years or less on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
	exists &quot;Colonoscopy Performed&quot;
		or exists &quot;Fecal Occult Blood Test Performed&quot;
		or exists &quot;Flexible Sigmoidoscopy Performed&quot;
		or exists &quot;Fecal Immunochemical Test DNA&quot;
		or exists &quot;CT Colonography Performed&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString value="define &quot;Denominator&quot;:
	true"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </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="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-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="10"/>
        </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="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
	Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[50, 75]
			and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </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="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-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="14"/>
        </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="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Malignant Neoplasm Ever"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Malignant Neoplasm Ever&quot;:
	[Condition: &quot;Malignant Neoplasm of Colon&quot;] ColorectalCancer
		where Global.&quot;Normalize Interval&quot;(ColorectalCancer.onset) starts on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Total Colectomy Performed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Total Colectomy Performed&quot;:
	[Procedure: &quot;Total Colectomy&quot;] Colectomy
		where Colectomy.status = 'completed'
			and Global.&quot;Normalize Interval&quot;(Colectomy.performed) starts on or before end of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-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 exists &quot;Malignant Neoplasm Ever&quot;
		or exists &quot;Total Colectomy Performed&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </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="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM130-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="20"/>
        </extension>
      </extension>
      <url
           value="http://hl7.org/fhir/uv/cqm/Library/effective-data-requirements-exm130"/>
      <version value="1.0.0"/>
      <name value="EffectiveDataRequirements"/>
      <title value="Module Definition Library - EXM130"/>
      <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"/>
      <description
                   value="This library is used as an example module definition in the FHIR Quality Measure Implementation Guide"/>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library SDE"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqm/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/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library AdultOutpatientEncounters"/>
        <resource
                  value="http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Hospice"/>
        <resource value="http://hl7.org/fhir/uv/cqm/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="Value set Colonoscopy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Fecal Occult Blood Test (FOBT)"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Flexible Sigmoidoscopy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set FIT DNA"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set CT Colonography"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
      </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 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 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 Malignant Neoplasm of Colon"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Total Colectomy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019"/>
      </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="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="period"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <mustSupport value="code"/>
        <mustSupport value="onset"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <mustSupport value="effective"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <mustSupport value="effective"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
        </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/2.16.840.1.113883.3.464.1003.108.12.1020"/>
        </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/2.16.840.1.113883.3.464.1003.198.12.1019"/>
        </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/2.16.840.1.113883.3.464.1003.108.12.1038"/>
        </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/2.16.840.1.113762.1.4.1108.15"/>
        </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/2.16.840.1.113883.3.464.1003.198.12.1010"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
        <mustSupport value="code"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="intent"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis">
    <valueCode value="boolean"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/software-system-example"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
    <valueCanonical value="#effective-data-requirements-exm130"/>
  </extension>
  <url value="http://hl7.org/fhir/uv/cqm/Measure/EXM130-FHIR"/>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
    <value value="130"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/>
    <value value="0034"/>
  </identifier>
  <version value="8.0.000"/>
  <name value="EXM130"/>
  <title value="EXM130 - Colorectal Cancer Screening Measure"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2022-02-22"/>
  <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="Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="venue"/>
      <display value="Venue"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes"/>
        <code value="ec"/>
        <display value="EC"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <purpose
           value="This measure has been developed to support improvement in clinical care."/>
  <copyright
             value="This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved."/>
  <approvalDate value="2016-01-01"/>
  <lastReviewDate value="2016-09-01"/>
  <effectivePeriod>
    <start value="2018-01-01"/>
    <end value="2018-12-31"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57024-2"/>
      <display value="Health Quality Measure Document"/>
    </coding>
  </topic>
  <library value="http://hl7.org/fhir/uv/cqm/Library/EXM130-FHIR"/>
  <disclaimer
              value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
      <display value="Proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <rationale
             value="Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017)."/>
  <clinicalRecommendationStatement
                                   value="The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)"/>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
      <display value="Increased score indicates improvement"/>
    </coding>
  </improvementNotation>
  <guidance
            value="Patient self-report for procedures as well as diagnostic studies should be recorded in &quot;Procedure, Performed&quot; template or &quot;Diagnostic Study, Performed&quot; template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE."/>
  <group>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exclusion"/>
          <display value="Denominator Exclusion"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exclusion"/>
      </criteria>
    </population>
  </group>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData>
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>