Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot
Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0-ballot: STU5 (v5.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions
| Active as of 2022-02-22 |
{
"resourceType" : "Measure",
"id" : "EXM125-FHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">EXM125-FHIR</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Download cql: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Library-EXM125-FHIR.cql\">EXM125-FHIR.cql</a></td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-EXM125-FHIR.html\">EXM125 - Breast Cancer Screening</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">5.0.0-ballot</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>125</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>112</span>\n </p>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">EXM125</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">EXM125 - Breast Cancer Screening</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">active</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Increased score indicates improvement </span>\n </p>\n \n \n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>process </span>\n </p>\n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2022-02-22</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">HL7 International / Clinical Quality Information</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer</p>\n</div></td>\n </tr>\n \n \n \n \n <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>code</b></th><th><b>value</b></th></tr>\n \n <tr>\n <td>program</td>\n <td></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Jurisdiction: </b></th>\n <td style=\"padding-left: 25px;\">US</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Topic: </b></th>\n <td style=\"padding-left: 25px;\">57024-2</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Women 51-74 years of age with a visit during the measurement period</p>\n</div></td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 25px;\"><div><p>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but 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 must be approved by NCQA and are subject to a license at the discretion of 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. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved.\nLimited 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 CPT or other codes contained in the specifications.\nCPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation. ICD-10 copyright 2016 World Health Organization. All Rights Reserved.\nThe American Hospital Association holds a copyright to the National Uniform Billing Committee (NUBC) codes contained in the measure specifications. The NUBC codes in the specifications are included with the permission of the AHA. The NUBC codes contained in the specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting Measure results or using Measure results for their internal quality improvement purposes. All other uses of the NUBC codes require a license from the AHA. Anyone desiring to use the NUBC codes in a commercial product to generate Measure results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@healthforum.com.</p>\n</div></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 25px;\"><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 "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>\n</div></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Approval Date: </b></th>\n <td style=\"padding-left: 4px;\">2016-01-01</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Last Review Date: </b></th>\n <td style=\"padding-left: 4px;\">2016-09-01</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n </tr>\n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n \n SDE Ethnicity\n \n \n \n \n \n \n \n SDE Payer\n \n \n \n \n \n \n \n SDE Race\n \n \n \n \n \n \n \n SDE Sex\n \n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr><td><a href=\"Library-EXM125-FHIR.html\">EXM125 - Breast Cancer Screening Library</a></td></tr>\n \n </table>\n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Related Artifact Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><a href=\"http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000\">http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000</a></li>\n \n <li><a href=\"http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>\n \n <li><a href=\"Library-MATGlobalCommonFunctions.html\">MAT Global Common Functions FHIR Library</a></li>\n \n <li><a href=\"http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000\">http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000</a></li>\n \n <li><a href=\"http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000\">http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000</a></li>\n \n <li><a href=\"http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709\">http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1018/expansion\">Mammography</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1020/expansion\">Unilateral Mastectomy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1070/expansion\">Status Post Right Mastectomy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1071/expansion\">Unilateral Mastectomy, Unspecified Laterality</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.122.12.1035/expansion\">Right</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1069/expansion\">Status Post Left Mastectomy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.122.12.1036/expansion\">Left</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1068/expansion\">History of bilateral mastectomy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1005/expansion\">Bilateral Mastectomy</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <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>\n \n <tr>\n <td>Measurement Period</td>\n <td>in</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>out</td>\n <td>0</td>\n <td>*</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Denominator Exclusion</td>\n <td>out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>out</td>\n <td>0</td>\n <td>*</td>\n <td>Coding</td>\n </tr>\n \n </table>\n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>\n \n <tr>\n <td>Coverage</td>\n <td>\n \n period\n \n type\n \n </td>\n <td>\n \n \n Payer\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>Patient</td>\n <td>\n \n extension\n \n value\n \n url\n \n </td>\n <td>\n \n </td>\n <td></td>\n </tr>\n \n <tr>\n <td>Condition</td>\n <td>\n \n code\n \n clinicalStatus\n \n </td>\n <td>\n \n \n Status Post Right Mastectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1070/expansion\">Status Post Right Mastectomy</a></td>\n </tr>\n \n <tr>\n <td>Condition</td>\n <td>\n \n code\n \n clinicalStatus\n \n </td>\n <td>\n \n \n Status Post Left Mastectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1069/expansion\">Status Post Left Mastectomy</a></td>\n </tr>\n \n <tr>\n <td>Condition</td>\n <td>\n \n bodySite\n \n code\n \n clinicalStatus\n \n </td>\n <td>\n \n \n Unilateral Mastectomy, Unspecified Laterality\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1071/expansion\">Unilateral Mastectomy, Unspecified Laterality</a></td>\n </tr>\n \n <tr>\n <td>Condition</td>\n <td>\n \n code\n \n clinicalStatus\n \n onset\n \n </td>\n <td>\n \n \n History of bilateral mastectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1068/expansion\">History of bilateral mastectomy</a></td>\n </tr>\n \n <tr>\n <td>Procedure</td>\n <td>\n \n code\n \n performed\n \n status\n \n </td>\n <td>\n \n \n Bilateral Mastectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1005/expansion\">Bilateral Mastectomy</a></td>\n </tr>\n \n <tr>\n <td>Procedure</td>\n <td>\n \n code\n \n performed\n \n status\n \n </td>\n <td>\n \n \n Unilateral Mastectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1020/expansion\">Unilateral Mastectomy</a></td>\n </tr>\n \n <tr>\n <td>Procedure</td>\n <td>\n \n code\n \n performed\n \n status\n \n </td>\n <td>\n \n \n Hospice care ambulatory\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n type\n \n </td>\n <td>\n \n \n Office Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n type\n \n </td>\n <td>\n \n \n Annual Wellness Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n type\n \n </td>\n <td>\n \n \n Preventive Care Services - Established Office Visit, 18 and Up\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n type\n \n </td>\n <td>\n \n \n Preventive Care Services-Initial Office Visit, 18 and Up\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n type\n \n </td>\n <td>\n \n \n Home Healthcare Services\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n period\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n type\n \n status\n \n </td>\n <td>\n \n \n Encounter Inpatient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest</td>\n <td>\n \n code\n \n authoredOn\n \n intent\n \n </td>\n <td>\n \n \n Hospice care ambulatory\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n </tr>\n \n <tr>\n <td>DiagnosticReport</td>\n <td>\n \n effective\n \n code\n \n status\n \n </td>\n <td>\n \n \n Mammography\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1018/expansion\">Mammography</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n \n <tr>\n <td>Discharge to home for hospice care (procedure)</td>\n <td>428361000124107</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></td>\n </tr>\n \n <tr>\n <td>Discharge to healthcare facility for hospice care (procedure)</td>\n <td>428371000124100</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></td>\n </tr>\n \n <tr>\n <td></td>\n <td>active</td>\n <td><a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> </td>\n <td>\n \n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population":\n\t\tPatient.gender = 'female'\n\t\t\t\tand Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[51, 74]\n\t\t\t\tand exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n\t\texists (\n\t\t\t\t[DiagnosticReport: "Mammography"] Mammogram\n\t\t\t\t\t\twhere ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less before day of end of "Measurement Period" )\n\t\t\t\t\t\t\t\tand Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }\n\t\t)</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n\t\t"Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusion":\n\t\tHospice."Has Hospice"\n\t\t\t\tor ( Count("Unilateral Mastectomy Procedure") = 2 )\n\t\t\t\tor ( exists "Right Mastectomy" and exists "Left Mastectomy" )\n\t\t\t\tor exists "History Bilateral Mastectomy"\n\t\t\t\tor exists "Bilateral Mastectomy Procedure"</code></pre>\n \n </td>\n </tr>\n \n\n \n </tr>\n </table>\n \n <table class=\"grid-dict\">\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n else null\n end</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n\t\texists (\n\t\t\t\t[DiagnosticReport: "Mammography"] Mammogram\n\t\t\t\t\t\twhere ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less before day of end of "Measurement Period" )\n\t\t\t\t\t\t\t\tand Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }\n\t\t)</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>AdultOutpatientEncounters</td>\n \n \n <td>Qualifying Encounters</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying Encounters":\n\t(\n [Encounter: "Office Visit"]\n \t\tunion [Encounter: "Annual Wellness Visit"]\n \t\tunion [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]\n \t\tunion [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]\n \t\tunion [Encounter: "Home Healthcare Services"]\n ) ValidEncounter\n\t\twhere ValidEncounter.period during "Measurement Period"\n \t\tand ValidEncounter.status = 'finished'</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n\t\tPatient.gender = 'female'\n\t\t\t\tand Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[51, 74]\n\t\t\t\tand exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n\t\t"Initial Population"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n (flatten (\n Patient.extension Extension\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n return Extension.extension\n )) E\n where E.url = 'ombCategory'\n or E.url = 'detailed'\n return E.value as Coding</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>Hospice</td>\n \n \n <td>Has Hospice</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Hospice":\n\texists (\n [Encounter: "Encounter Inpatient"] DischargeHospice\n\t\t\twhere DischargeHospice.status = 'finished'\n\t\t and (\n\t DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"\n\t\t\t\t or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"\n\t \t)\n\t\t\t\tand DischargeHospice.period ends during "Measurement Period"\n\t)\n or exists (\n [ServiceRequest: "Hospice care ambulatory"] HospiceOrder\n where HospiceOrder.intent = 'order'\n and HospiceOrder.authoredOn in "Measurement Period"\n )\n or exists (\n [Procedure: "Hospice care ambulatory"] HospicePerformed\n where HospicePerformed.status = 'completed'\n and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"\n )</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Unilateral Mastectomy Procedure</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Unilateral Mastectomy Procedure":\n\t\t[Procedure: "Unilateral Mastectomy"] UnilateralMastectomyProcedure\n\t\t\t\twhere Global."Normalize Interval"(UnilateralMastectomyProcedure.performed) ends before day of end of "Measurement Period"\n\t\t\t\t\t\tand UnilateralMastectomyProcedure.status = 'completed'</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Right Mastectomy</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Right Mastectomy":\n\t\t(\n\t\t\t\t( [Condition: "Status Post Right Mastectomy"] C\n where C.clinicalStatus ~ ToConcept(Global."active")\n )\n\t\t\t\tunion (\n\t\t\t\t\t\t[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis\n\t\t\t\t\t\t\t\twhere UnilateralMastectomyDiagnosis.bodySite in "Right"\n and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")\n\t\t\t\t)\n\t\t) RightMastectomy\n\t\t\t\twhere Global."Normalize Interval"(RightMastectomy.onset) starts before day of end of "Measurement Period"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Left Mastectomy</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Left Mastectomy":\n\t\t(\n\t\t ( [Condition: "Status Post Left Mastectomy"] C\n where C.clinicalStatus ~ ToConcept(Global."active")\n )\n\t\t\t\tunion (\n\t\t\t\t\t\t[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis\n\t\t\t\t\t\t\t\twhere UnilateralMastectomyDiagnosis.bodySite in "Left"\n and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")\n\t\t\t\t)\n\t\t) LeftMastectomy\n\t\t\t\twhere Global."Normalize Interval"(LeftMastectomy.onset) starts before day of end of "Measurement Period"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>History Bilateral Mastectomy</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "History Bilateral Mastectomy":\n\t\t[Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory\n\t\t\t\twhere Global."Normalize Interval"(BilateralMastectomyHistory.onset) starts before day of end of "Measurement Period"\n and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global."active")</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Bilateral Mastectomy Procedure</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Bilateral Mastectomy Procedure":\n\t\t[Procedure: "Bilateral Mastectomy"] BilateralMastectomyPerformed\n\t\t\t\twhere Global."Normalize Interval"(BilateralMastectomyPerformed.performed) ends before day of end of "Measurement Period"\n\t\t\t\t\t\tand BilateralMastectomyPerformed.status = 'completed'</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>Denominator Exclusion</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusion":\n\t\tHospice."Has Hospice"\n\t\t\t\tor ( Count("Unilateral Mastectomy Procedure") = 2 )\n\t\t\t\tor ( exists "Right Mastectomy" and exists "Left Mastectomy" )\n\t\t\t\tor exists "History Bilateral Mastectomy"\n\t\t\t\tor exists "Bilateral Mastectomy Procedure"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n (flatten (\n Patient.extension Extension\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n return Extension.extension\n )) E\n where E.url = 'ombCategory'\n or E.url = 'detailed'\n return E.value as Coding</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXM125-FHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre></td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"version" : "http://snomed.info/sct/731000124108/version/201709",
"code" : "428361000124107",
"display" : "Discharge to home for hospice care (procedure)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"version" : "http://snomed.info/sct/731000124108/version/201709",
"code" : "428371000124100",
"display" : "Discharge to healthcare facility for hospice care (procedure)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n\t\texists (\n\t\t\t\t[DiagnosticReport: \"Mammography\"] Mammogram\n\t\t\t\t\t\twhere ( Global.\"Normalize Interval\"(Mammogram.effective) ends 27 months or less before day of end of \"Measurement Period\" )\n\t\t\t\t\t\t\t\tand Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }\n\t\t)"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "AdultOutpatientEncounters"
},
{
"url" : "name",
"valueString" : "Qualifying Encounters"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying Encounters\":\n\t(\n [Encounter: \"Office Visit\"]\n \t\tunion [Encounter: \"Annual Wellness Visit\"]\n \t\tunion [Encounter: \"Preventive Care Services - Established Office Visit, 18 and Up\"]\n \t\tunion [Encounter: \"Preventive Care Services-Initial Office Visit, 18 and Up\"]\n \t\tunion [Encounter: \"Home Healthcare Services\"]\n ) ValidEncounter\n\t\twhere ValidEncounter.period during \"Measurement Period\"\n \t\tand ValidEncounter.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n\t\tPatient.gender = 'female'\n\t\t\t\tand Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of \"Measurement Period\") in Interval[51, 74]\n\t\t\t\tand exists AdultOutpatientEncounters.\"Qualifying Encounters\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n\t\t\"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n (flatten (\n Patient.extension Extension\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n return Extension.extension\n )) E\n where E.url = 'ombCategory'\n or E.url = 'detailed'\n return E.value as Coding"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Hospice"
},
{
"url" : "name",
"valueString" : "Has Hospice"
},
{
"url" : "statement",
"valueString" : "define \"Has Hospice\":\n\texists (\n [Encounter: \"Encounter Inpatient\"] DischargeHospice\n\t\t\twhere DischargeHospice.status = 'finished'\n\t\t and (\n\t DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n\t\t\t\t or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n\t \t)\n\t\t\t\tand DischargeHospice.period ends during \"Measurement Period\"\n\t)\n or exists (\n [ServiceRequest: \"Hospice care ambulatory\"] HospiceOrder\n where HospiceOrder.intent = 'order'\n and HospiceOrder.authoredOn in \"Measurement Period\"\n )\n or exists (\n [Procedure: \"Hospice care ambulatory\"] HospicePerformed\n where HospicePerformed.status = 'completed'\n and Global.\"Normalize Interval\"(HospicePerformed.performed) overlaps \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Unilateral Mastectomy Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Unilateral Mastectomy Procedure\":\n\t\t[Procedure: \"Unilateral Mastectomy\"] UnilateralMastectomyProcedure\n\t\t\t\twhere Global.\"Normalize Interval\"(UnilateralMastectomyProcedure.performed) ends before day of end of \"Measurement Period\"\n\t\t\t\t\t\tand UnilateralMastectomyProcedure.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Right Mastectomy"
},
{
"url" : "statement",
"valueString" : "define \"Right Mastectomy\":\n\t\t(\n\t\t\t\t( [Condition: \"Status Post Right Mastectomy\"] C\n where C.clinicalStatus ~ ToConcept(Global.\"active\")\n )\n\t\t\t\tunion (\n\t\t\t\t\t\t[Condition: \"Unilateral Mastectomy, Unspecified Laterality\"] UnilateralMastectomyDiagnosis\n\t\t\t\t\t\t\t\twhere UnilateralMastectomyDiagnosis.bodySite in \"Right\"\n and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global.\"active\")\n\t\t\t\t)\n\t\t) RightMastectomy\n\t\t\t\twhere Global.\"Normalize Interval\"(RightMastectomy.onset) starts before day of end of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Left Mastectomy"
},
{
"url" : "statement",
"valueString" : "define \"Left Mastectomy\":\n\t\t(\n\t\t ( [Condition: \"Status Post Left Mastectomy\"] C\n where C.clinicalStatus ~ ToConcept(Global.\"active\")\n )\n\t\t\t\tunion (\n\t\t\t\t\t\t[Condition: \"Unilateral Mastectomy, Unspecified Laterality\"] UnilateralMastectomyDiagnosis\n\t\t\t\t\t\t\t\twhere UnilateralMastectomyDiagnosis.bodySite in \"Left\"\n and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global.\"active\")\n\t\t\t\t)\n\t\t) LeftMastectomy\n\t\t\t\twhere Global.\"Normalize Interval\"(LeftMastectomy.onset) starts before day of end of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "History Bilateral Mastectomy"
},
{
"url" : "statement",
"valueString" : "define \"History Bilateral Mastectomy\":\n\t\t[Condition: \"History of bilateral mastectomy\"] BilateralMastectomyHistory\n\t\t\t\twhere Global.\"Normalize Interval\"(BilateralMastectomyHistory.onset) starts before day of end of \"Measurement Period\"\n and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global.\"active\")"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Bilateral Mastectomy Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Bilateral Mastectomy Procedure\":\n\t\t[Procedure: \"Bilateral Mastectomy\"] BilateralMastectomyPerformed\n\t\t\t\twhere Global.\"Normalize Interval\"(BilateralMastectomyPerformed.performed) ends before day of end of \"Measurement Period\"\n\t\t\t\t\t\tand BilateralMastectomyPerformed.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exclusion"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusion\":\n\t\tHospice.\"Has Hospice\"\n\t\t\t\tor ( Count(\"Unilateral Mastectomy Procedure\") = 2 )\n\t\t\t\tor ( exists \"Right Mastectomy\" and exists \"Left Mastectomy\" )\n\t\t\t\tor exists \"History Bilateral Mastectomy\"\n\t\t\t\tor exists \"Bilateral Mastectomy Procedure\""
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n (flatten (\n Patient.extension Extension\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n return Extension.extension\n )) E\n where E.url = 'ombCategory'\n or E.url = 'detailed'\n return E.value as Coding"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM125-FHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"date" : "2022-02-22T10:37:03-07:00",
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"display" : "Library Global",
"resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"
},
{
"type" : "depends-on",
"display" : "Library AdultOutpatientEncounters",
"resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000"
},
{
"type" : "depends-on",
"display" : "Library Hospice",
"resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT:2017-09",
"resource" : "http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"
},
{
"type" : "depends-on",
"display" : "Code system ConditionClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
},
{
"type" : "depends-on",
"display" : "Value set Mammography",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018"
},
{
"type" : "depends-on",
"display" : "Value set Office Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"type" : "depends-on",
"display" : "Value set Annual Wellness Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services - Established Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services-Initial Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
},
{
"type" : "depends-on",
"display" : "Value set Home Healthcare Services",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
},
{
"type" : "depends-on",
"display" : "Value set Payer",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
},
{
"type" : "depends-on",
"display" : "Value set Encounter Inpatient",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
},
{
"type" : "depends-on",
"display" : "Value set Hospice care ambulatory",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
},
{
"type" : "depends-on",
"display" : "Value set Unilateral Mastectomy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020"
},
{
"type" : "depends-on",
"display" : "Value set Status Post Right Mastectomy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070"
},
{
"type" : "depends-on",
"display" : "Value set Unilateral Mastectomy, Unspecified Laterality",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071"
},
{
"type" : "depends-on",
"display" : "Value set Right",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035"
},
{
"type" : "depends-on",
"display" : "Value set Status Post Left Mastectomy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069"
},
{
"type" : "depends-on",
"display" : "Value set Left",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036"
},
{
"type" : "depends-on",
"display" : "Value set History of bilateral mastectomy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068"
},
{
"type" : "depends-on",
"display" : "Value set Bilateral Mastectomy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "Denominator Exclusion",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
}
],
"dataRequirement" : [
{
"type" : "Coverage",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
],
"mustSupport" : [
"period",
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
},
{
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
],
"mustSupport" : [
"extension",
"value",
"url"
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"code",
"clinicalStatus"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070"
}
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"code",
"clinicalStatus"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069"
}
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"bodySite",
"code",
"clinicalStatus"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071"
}
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"code",
"clinicalStatus",
"onset"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"performed",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"type"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"period",
"hospitalization",
"hospitalization.dischargeDisposition",
"type",
"status"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
}
]
},
{
"type" : "ServiceRequest",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
],
"mustSupport" : [
"code",
"authoredOn",
"intent"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
}
]
},
{
"type" : "DiagnosticReport",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
],
"mustSupport" : [
"effective",
"code",
"status"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018"
}
]
}
]
}
],
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cqi"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/EXM125-FHIR",
"identifier" : [
{
"use" : "official",
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms",
"value" : "125"
},
{
"use" : "official",
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/mips",
"value" : "112"
}
],
"version" : "5.0.0-ballot",
"name" : "EXM125",
"title" : "EXM125 - Breast Cancer Screening",
"status" : "active",
"experimental" : true,
"date" : "2022-02-22",
"publisher" : "HL7 International / Clinical Quality Information",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"description" : "Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer",
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "program"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
"code" : "ep-ec",
"display" : "EP/EC"
}
]
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"purpose" : "Women 51-74 years of age with a visit during the measurement period",
"copyright" : "This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but 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 must be approved by NCQA and are subject to a license at the discretion of 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. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. \n 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 CPT or other codes contained in the specifications. \n CPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation. ICD-10 copyright 2016 World Health Organization. All Rights Reserved. \n The American Hospital Association holds a copyright to the National Uniform Billing Committee (NUBC) codes contained in the measure specifications. The NUBC codes in the specifications are included with the permission of the AHA. The NUBC codes contained in the specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting Measure results or using Measure results for their internal quality improvement purposes. All other uses of the NUBC codes require a license from the AHA. Anyone desiring to use the NUBC codes in a commercial product to generate Measure results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@healthforum.com.",
"approvalDate" : "2016-01-01",
"lastReviewDate" : "2016-09-01",
"effectivePeriod" : {
"start" : "2018-01-01",
"end" : "2018-12-31"
},
"topic" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57024-2",
"display" : "Health Quality Measure Document"
}
]
}
],
"library" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/Library/EXM125-FHIR"
],
"disclaimer" : "The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
}
]
}
],
"rationale" : "Breast cancer is one of the most common types of cancers, accounting for a quarter of all new cancer diagnoses for women in the U.S. (BreastCancer.Org, 2011). It ranks as the second leading cause of cancer-related mortality in women, accounting for nearly 40,000 estimated deaths in 2013 (American Cancer Society, 2011). \n According to the National Cancer Institute's Surveillance Epidemiology and End Results program, the chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 30, it is one in 2,212. By age 40, the chances increase to one in 235, by age 50, it becomes one in 54, and, by age 60, it is one in 25. From 2004 to 2008, the median age at the time of breast cancer diagnosis was 61 years among adult women (Tangka et al, 2010). \n In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits, and varying procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (Lavigne et al, 2008; Boykoff et al, 2009).",
"clinicalRecommendationStatement" : "The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation). The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms (C recommendation). The Task Force concludes the evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years and older (I statement). \n U.S. Preventive Services Task Force (2009) \n Grade: B recommendation. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. \n Grade: C recommendation. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. \n Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. \n Grade: D recommendation. The USPSTF recommends against teaching breast self-examination (BSE). \n Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. \n Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.",
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
},
"guidance" : "Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1. Patient self-report is not allowed for laboratory tests. \n This measure evaluates primary screening. Do not count biopsies, breast ultrasounds, MRIs or tomosynthesis (3D mammography), because they are not appropriate methods for primary breast cancer screening.",
"group" : [
{
"population" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusion"
}
}
]
}
],
"supplementalData" : [
{
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.cqfmeasures#5.0.0-ballot based on FHIR 4.0.1. Generated 2023-12-15
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QA Report
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