Quality Measure Implementation Guide
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Quality Measure Implementation Guide - Downloaded Version null See the Directory of published versions

## Library: CCS Component Library

Official URL: http://hl7.org/fhir/uv/cqm/Library/CCSComponent | Version: 0.0.001 | Highlight text changes?
Standards status: Trial-use Draft as of 2026-04-07 | Maturity Level: 4 | Computable Name: CCSComponent
Other Identifiers: OID:2.16.840.1.113883.4.642.40.61.28.5

This library is the primary measure library for the Cervical Cancer Screening component of the composite measure examples in this implementation guide.

Metadata
Title | CCS Component Library
Version | 0.0.001
Identifier | urn:oid:2.16.840.1.113883.4.642.40.61.28.5
Status | Draft
Jurisdiction | 001 from http://unstats.un.org/unsd/methods/m49/m49.htm
Steward (Publisher) | HL7 International / Clinical Quality Information
Description | This library is the primary measure library for the Cervical Cancer Screening component of the composite measure examples in this implementation guide.
Type | logic-library from http://terminology.hl7.org/CodeSystem/library-type
Dependency | Description: Library FHIRHelpers Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 Canonical URL: `http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1`
Dependency | Description: Library SDE Resource: Supplemental Data Elementsversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000`
Dependency | Description: Library Global Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000`
Dependency | Description: Library AdultOutpatientEncounters Resource: Adult Outpatient Encounters Common Libraryversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000`
Dependency | Description: Library Hospice Resource: Hospice FHIR Libraryversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/Hospice|2.0.000`
Dependency | Description: Library Frailty Resource: Advanced Illness and Frailty Exclusion Libraryversion: null5.12.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/AdvancedIllnessandFrailtyExclusion|5.12.000`
Dependency | Description: Code System LOINC Resource: Logical Observation Identifiers, Names and Codes (LOINC) Canonical URL: `http://loinc.org`
Dependency | Description: Value Set Acute Inpatient Resource: Acute Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083`
Dependency | Description: Value Set Advanced Illness Resource: Advanced Illness Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082`
Dependency | Description: Value Set Annual Wellness Visit Resource: Annual Wellness Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240`
Dependency | Description: Value Set Care Services in Long-Term Residential Facility Resource: Care Services in Long Term Residential Facility Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014`
Dependency | Description: Value Set Colonoscopy Resource: Colonoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020`
Dependency | Description: Value Set CT Colonography Resource: CT Colonography Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038`
Dependency | Description: Value Set Dementia Medications Resource: Dementia Medications Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510`
Dependency | Description: Value Set Discharged to Health Care Facility for Hospice Care Resource: Discharged to Health Care Facility for Hospice Care Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207`
Dependency | Description: Value Set Discharged to Home for Hospice Care Resource: Discharged to Home for Hospice Care Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209`
Dependency | Description: Value Set ED Resource: ED Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085`
Dependency | Description: Value Set Encounter Inpatient Resource: Encounter Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307`
Dependency | Description: Value Set Fecal Occult Blood Test (FOBT) Resource: Fecal Occult Blood Test (FOBT) Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011`
Dependency | Description: Value Set FIT DNA Resource: sDNA FIT Test Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039`
Dependency | Description: Value Set Flexible Sigmoidoscopy Resource: Flexible Sigmoidoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010`
Dependency | Description: Value Set Frailty Device Resource: Frailty Device Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300`
Dependency | Description: Value Set Frailty Diagnosis Resource: Frailty Diagnosis Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074`
Dependency | Description: Value Set Frailty Encounter Resource: Frailty Encounter Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088`
Dependency | Description: Value Set Frailty Symptom Resource: Frailty Symptom Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075`
Dependency | Description: Value Set Home Healthcare Services Resource: Home Healthcare Services Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016`
Dependency | Description: Value Set Hospice care ambulatory Resource: Hospice Care Ambulatory Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15`
Dependency | Description: Value Set Malignant Neoplasm of Colon Resource: Malignant Neoplasm of Colon Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001`
Dependency | Description: Value Set Nonacute Inpatient Resource: Nonacute Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084`
Dependency | Description: Value Set Nursing Facility Visit Resource: Nursing Facility Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012`
Dependency | Description: Value Set Observation Resource: Observation Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086`
Dependency | Description: Value Set Office Visit Resource: Office Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001`
Dependency | Description: Value Set Outpatient Resource: Outpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087`
Dependency | Description: Value Set Preventive Care Services - Established Office Visit, 18 and Up Resource: Preventive Care Services Established Office Visit, 18 and Up Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025`
Dependency | Description: Value Set Preventive Care Services-Initial Office Visit, 18 and Up Resource: Preventive Care Services Initial Office Visit, 18 and Up Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023`
Dependency | Description: Value Set Total Colectomy Resource: Total Colectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019`
Data Requirement | Type: Procedure Profile(s): Procedure Code Filter(s): Path: code ValueSet: Flexible Sigmoidoscopy
Data Requirement | Type: Procedure Profile(s): Procedure Code Filter(s): Path: code ValueSet: CT Colonography
Data Requirement | Type: Procedure Profile(s): Procedure Code Filter(s): Path: code ValueSet: Total Colectomy
Data Requirement | Type: Observation Profile(s): Observation Code Filter(s): Path: code ValueSet: Fecal Occult Blood Test (FOBT)
Data Requirement | Type: Observation Profile(s): Observation Code Filter(s): Path: code ValueSet: sDNA FIT Test
Data Requirement | Type: Procedure Profile(s): Procedure Code Filter(s): Path: code ValueSet: Colonoscopy
Data Requirement | Type: Condition Profile(s): Condition Code Filter(s): Path: code ValueSet: Malignant Neoplasm of Colon
Parameters
Name | Use | Card. | Type | Documentation
Measurement Period | In | 0..1 | Period |
Patient | Out | 0..1 | Patient |
SDE Ethnicity | Out | 0..* | Coding |
SDE Payer | Out | 0..* | Resource |
SDE Race | Out | 0..* | Coding |
SDE Sex | Out | 0..1 | Coding |
Initial Population | Out | 0..1 | boolean |
Denominator | Out | 0..1 | boolean |
Flexible Sigmoidoscopy Performed | Out | 0..* | Procedure |
CT Colonography Performed | Out | 0..* | Procedure |
Total Colectomy Performed | Out | 0..* | Procedure |
Fecal Occult Blood Test Performed | Out | 0..* | Observation |
Fecal Immunochemical Test DNA | Out | 0..* | Observation |
Colonoscopy Performed | Out | 0..* | Procedure |
Numerator | Out | 0..1 | boolean |
Malignant Neoplasm | Out | 0..* | Condition |
Denominator Exclusion | Out | 0..1 | boolean |
Library Content
CQL Content |
    /*
    This example is a work in progress and should not be considered a final specification
    or recommendation for guidance. This example will help guide and direct the process
    of finding conventions and usage patterns that meet the needs of the various stakeholders
    in the measure development community.
    */
    library CCSComponent version '0.0.001'

    using FHIR version '4.0.1'

    include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers

    include SupplementalDataElements version '2.0.000' called SDE
    include MATGlobalCommonFunctions version '5.0.000' called Global
    include AdultOutpatientEncounters version '2.0.000' called AdultOutpatientEncounters
    include Hospice version '2.0.000' called Hospice
    include AdvancedIllnessandFrailtyExclusion version '5.12.000' called Frailty

    codesystem "LOINC": 'http://loinc.org'

    valueset "Acute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083'
    valueset "Advanced Illness": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082'
    valueset "Annual Wellness Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240'
    valueset "Care Services in Long-Term Residential Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014'
    valueset "Colonoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020'
    valueset "CT Colonography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038'
    valueset "Dementia Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510'
    valueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'
    valueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'
    valueset "ED": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085'
    valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
    valueset "Fecal Occult Blood Test (FOBT)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011'
    valueset "FIT DNA": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039'
    valueset "Flexible Sigmoidoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010'
    valueset "Frailty Device": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300'
    valueset "Frailty Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074'
    valueset "Frailty Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088'
    valueset "Frailty Symptom": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075'
    valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'
    valueset "Hospice care ambulatory": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15'
    valueset "Malignant Neoplasm of Colon": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001'
    valueset "Nonacute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084'
    valueset "Nursing Facility Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012'
    valueset "Observation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086'
    valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
    valueset "Outpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087'
    valueset "Preventive Care Services - Established Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025'
    valueset "Preventive Care Services-Initial Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023'
    valueset "Total Colectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019'

    code "Birth date": '21112-8' from "LOINC" display 'Birth date'

    parameter "Measurement Period" Interval<DateTime>

    context Patient

    define "SDE Ethnicity":
      SDE."SDE Ethnicity"

    define "SDE Payer":
      SDE."SDE Payer"

    define "SDE Race":
      SDE."SDE Race"

    define "SDE Sex":
      SDE."SDE Sex"

    define "Initial Population":
      Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of "Measurement Period" ) in Interval[50, 75]
          and exists AdultOutpatientEncounters."Qualifying Encounters"

    define "Denominator":
      "Initial Population"

    define "Flexible Sigmoidoscopy Performed":
      [Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
          where FlexibleSigmoidoscopy.status = 'completed'
            and Global."Normalize Interval" ( FlexibleSigmoidoscopy.performed ) ends 5 years or less on or before
            end of "Measurement Period"

    define "CT Colonography Performed":
      [Procedure: "CT Colonography"] Colonography
          where Colonography.status = 'completed'
            and Global."Normalize Interval" ( Colonography.performed ) ends 5 years or less on or before
            end of "Measurement Period"

    define "Total Colectomy Performed":
      [Procedure: "Total Colectomy"] Colectomy
          where Colectomy.status = 'completed'
            and Global."Normalize Interval" ( Colectomy.performed ) starts on or before
            end of "Measurement Period"

    define "Fecal Occult Blood Test Performed":
      [Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
          where FecalOccultResult.status in { 'final', 'amended', 'corrected', 'preliminary' }
            and FecalOccultResult.value is not null
            and Global."Normalize Interval" ( FecalOccultResult.effective ) during day of "Measurement Period"

    define "Fecal Immunochemical Test DNA":
      [Observation: "FIT DNA"] FitDNA
          where FitDNA.status in { 'final', 'amended', 'corrected', 'preliminary' }
            and FitDNA.value is not null
            and Global."Normalize Interval" ( FitDNA.effective ) occurs 3 years or less on or before day of
            end of "Measurement Period"

    define "Colonoscopy Performed":
      [Procedure: "Colonoscopy"] Colonoscopy
          where Colonoscopy.status = 'completed'
            and Global."Normalize Interval" ( Colonoscopy.performed ) ends 10 years or less on or before
            end of "Measurement Period"

    define "Numerator":
      exists "Colonoscopy Performed"
          or exists "Fecal Occult Blood Test Performed"
          or exists "Flexible Sigmoidoscopy Performed"
          or exists "Fecal Immunochemical Test DNA"
          or exists "CT Colonography Performed"

    define "Malignant Neoplasm":
      [Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
          where Global."Prevalence Period" ( ColorectalCancer ) starts on or before
          end of "Measurement Period"

    define "Denominator Exclusion":
      Hospice."Has Hospice"
          or exists "Malignant Neoplasm"
          or exists "Total Colectomy Performed"
          or Frailty."Advanced Illness and Frailty Exclusion Not Including Over Age 80"
            and Frailty."Long Term Care Periods Longer Than 90 Consecutive Days"
ELM XML Content |
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ELM JSON Content |
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Generated using version 0.5.4 of the sample-content-ig Liquid templates