# eCQM Update 2024 - Release - Quality Measure Implementation Guide v2.0.0-ballot

## Library: eCQM Update 2024 - Release (Experimental) 

 
This library is an example release of a version manifest (also referred to as an expansion profile) that specifies expansion rules for a set of value sets used for an example set of EP/EC measures. 

* Metadata: Title
  * ?: eCQM Update 2024 - Release
* Metadata: Version
  * ?: 1.0.0
* Metadata: Identifier
  * ?: eCQM Update 2024
* Metadata: Identifier
  * ?: urn:oid:2.16.840.1.113883.4.642.40.61.28.28
* Metadata: Approval Date
  * ?: 2024-04-23
* Metadata: Last Review Date
  * ?: 2024-04-23
* Metadata: Experimental
  * ?: true
* Metadata: Jurisdiction
  * ?: 001 from[http://unstats.un.org/unsd/methods/m49/m49.htm](http://unstats.un.org/unsd/methods/m49/m49.htm)
* Metadata: Steward (Publisher)
  * ?: HL7 International / Clinical Quality Information
* Metadata: Description
  * ?: This library is an example release of a version manifest (also referred to as an expansion profile) that specifies expansion rules for a set of value sets used for an example set of EP/EC measures.
* Metadata: Purpose
  * ?: This library is defined to illustrate a Version Manifest in release status, as it would look as part of the final publication an eCQM Annual Update cycle, approved on April 23rd, 2024, and published on May 2nd, 2024. The versions of code systems and value sets used by the measures is specified in the dependency references to provide stability for value set expansion for any use of the published content. Terminology.HL7.org, in particular, was version 5.5.0 at the time, and FHIR code system versions are chosen from that release.
* Metadata: Type
  * ?: asset-collection from[http://terminology.hl7.org/CodeSystem/library-type](http://terminology.hl7.org/7.1.0/CodeSystem-library-type.html)
* Metadata: Component
  * ?: **Description**: EXM55 - Median Emergency Department Visit Duration, 5.0.0**Resource**:[EXM55 - Median Emergency Department Visit Durationversion: null5.0.0)](Measure-EXM55-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR|5.0.0
* Metadata: Component
  * ?: **Description**: EXM108 - Venous Thromboembolism Prophylaxis, 8.2.000**Resource**:[EXM108 - Venous Thromboembolism Prophylaxisversion: null8.2.000)](Measure-EXM108-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM108-FHIR|8.2.000
* Metadata: Component
  * ?: **Description**: EXM124 - Cervical Cancer Screening, 9.0.000**Resource**:[EXM124 - Cervical Cancer Screeningversion: null9.0.000)](Measure-EXM124-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM124-FHIR|9.0.000
* Metadata: Component
  * ?: **Description**: EXM125 - Breast Cancer Screening, 8.0.000**Resource**:[EXM125 - Breast Cancer Screeningversion: null8.0.000)](Measure-EXM125-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM125-FHIR|8.0.000
* Metadata: Component
  * ?: **Description**: EXM130 - Colorectal Cancer Screening Measure, 8.0.000**Resource**:[EXM130 - Colorectal Cancer Screening Measureversion: null8.0.000)](Measure-EXM130-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM130-FHIR|8.0.000
* Metadata: Component
  * ?: **Description**: EXM146 - Appropriate Testing for Children with Pharyngitis, 4.0.0**Resource**:[EXM146 - Appropriate Testing for Children with Pharyngitisversion: null4.0.0)](Measure-EXM146-FHIR.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Measure/EXM146-FHIR|4.0.0
* Metadata: Dependency
  * ?: **Resource**:`http://hl7.org/fhir/uv/cqm/Library/Common|2.0.000`**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/Common|2.0.000
* Metadata: Dependency
  * ?: **Resource**:`http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.0`**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.0
* Metadata: Dependency
  * ?: **Resource**:[TJC Overall Libraryversion: null4.0.000)](Library-TJCOverall.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/TJCOverall|4.0.000
* Metadata: Dependency
  * ?: **Resource**:[Diagnosis Role](http://terminology.hl7.org/7.1.0/CodeSystem-diagnosis-role.html)**Canonical URL**:http://terminology.hl7.org/CodeSystem/diagnosis-role
* Metadata: Dependency
  * ?: **Resource**:[MedicationRequest Category Codes](http://terminology.hl7.org/7.1.0/CodeSystem-medicationrequest-category.html)**Canonical URL**:http://terminology.hl7.org/CodeSystem/medicationrequest-category
* Metadata: Dependency
  * ?: **Resource**:[AdministrativeGender](http://hl7.org/fhir/R4/codesystem-administrative-gender.html)**Canonical URL**:http://hl7.org/fhir/administrative-gender
* Metadata: Dependency
  * ?: **Resource**:[Antithrombotic Therapy for Ischemic Strokeversion: null20210409)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.62/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62|20210409
* Metadata: Dependency
  * ?: **Resource**:[Medical Reason For Not Providing Treatmentversion: null20220212)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.473/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473|20220212
* Metadata: Dependency
  * ?: **Resource**:[Patient Refusalversion: null20230117)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.93/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93|20230117
* Metadata: Dependency
  * ?: **Resource**:[Pharmacological Contraindications For Antithrombotic Therapyversion: null20220219)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.52/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52|20220219
* Metadata: Dependency
  * ?: **Resource**:[Nonelective Inpatient Encounterversion: null20210220)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.424/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424|20210220
* Metadata: Dependency
  * ?: **Resource**:[Ischemic Strokeversion: null20210220)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.247/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247|20210220
* Metadata: Dependency
  * ?: **Resource**:[Comfort Measuresversion: null20210220)](https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45|20210220
* Metadata: Dependency
  * ?: **Resource**:[Observation Servicesversion: null20210611)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143|20210611
* Metadata: Dependency
  * ?: **Resource**:[Emergency Department Visitversion: null20210611)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292|20210611
* Metadata: Dependency
  * ?: **Resource**:[Discharge To Acute Care Facilityversion: null20210611)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.87/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87|20210611
* Metadata: Dependency
  * ?: **Resource**:[Left Against Medical Adviceversion: null20210220)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.308/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308|20210220
* Metadata: Dependency
  * ?: **Resource**:[Patient Expiredversion: null20210611)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.309/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309|20210611
* Metadata: Dependency
  * ?: **Resource**:[Discharged to Home for Hospice Careversion: null20210220)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.209/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209|20210220
* Metadata: Dependency
  * ?: **Resource**:[Discharged to Health Care Facility for Hospice Careversion: null20210611)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.207/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207|20210611
* Metadata: Dependency
  * ?: **Resource**:[Payer Typeversion: null20221118)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591|20221118
* Metadata:  Parameters
* Metadata: Parameter
  * ?: None
* Metadata:  Expansion Parameters
* Metadata: 
  * ?: 
| | |
| :--- | :--- |
| **Name** | **Value** |
| system-version | `http://snomed.info/sct|http://snomed.info/sct/731000124108/version/20230901` |
| system-version | `http://loinc.org|2.76` |
| system-version | [ActCodeversion: null9.0.0)](http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html) |
| system-version | [AdministrativeGenderversion: null3.0.0)](http://terminology.hl7.org/6.5.0/CodeSystem-v3-AdministrativeGender.html) |
| system-version | [CDT-2 Codesversion: null2.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-CD2.html) |
| system-version | [Current Procedural Terminology (CPT®)version: null3.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-CPT.html) |
| system-version | [Vaccine Administered Code Set (CVX)version: null4.0.0)](http://terminology.hl7.org/5.5.0/CodeSystem-CVX.html) |
| system-version | [HCFA Procedure Codes (HCPCS)version: null3.0.0)](http://terminology.hl7.org/6.5.0/CodeSystem-HCPCS-all-codes.html) |
| system-version | [Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codesversion: null1.0.2)](http://terminology.hl7.org/6.5.0/CodeSystem-hcpcs-Level-II.html) |
| system-version | [International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)version: null2.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-icd10CM.html) |
| system-version | [ICD-10 Procedure Codesversion: null2.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-icd10PCS.html) |
| system-version | [ICD-9CMversion: null2.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-icd9cm.html) |
| system-version | [nubc-PresentOnAdmission-csversion: null2.2.0)](http://terminology.hl7.org/6.5.0/CodeSystem-v2-0895.html) |
| system-version | [RxNormversion: null3.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-v3-rxNorm.html) |
| system-version | [Source of Payment Typologyversion: null1.0.1)](http://terminology.hl7.org/6.5.0/CodeSystem-SOPT.html) |

* Metadata: Generated using version 0.5.4 of the sample-content-ig Liquid templates



## Resource Content

```json
{
  "resourceType" : "Library",
  "id" : "Manifest-Release",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-manifestlibrary"]
  },
  "contained" : [{
    "resourceType" : "Parameters",
    "id" : "exp-params",
    "parameter" : [{
      "name" : "system-version",
      "valueCanonical" : "http://snomed.info/sct|http://snomed.info/sct/731000124108/version/20230901"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://loinc.org|2.76"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/v3-ActCode|9.0.0"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/v3-AdministrativeGender|3.0.0"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/CD2|2.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://www.ama-assn.org/go/cpt|3.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://hl7.org/fhir/sid/cvx|4.0.0"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/HCPCS-all-codes|3.0.0"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets|1.0.2"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://hl7.org/fhir/sid/icd-10-cm|2.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://www.cms.gov/Medicare/Coding/ICD10|2.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/icd9cm|2.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://terminology.hl7.org/CodeSystem/v2-0895|2.2.0"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "http://www.nlm.nih.gov/research/umls/rxnorm|3.0.1"
    },
    {
      "name" : "system-version",
      "valueCanonical" : "https://nahdo.org/sopt|1.0.1"
    }]
  }],
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expansionParameters",
    "valueReference" : {
      "reference" : "#exp-params"
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cqi"
  }],
  "url" : "http://hl7.org/fhir/uv/cqm/Library/Manifest-Release",
  "identifier" : [{
    "use" : "official",
    "system" : "http://example.org/fhir/cqi/ecqm/Library/Identifier",
    "value" : "eCQM Update 2024"
  },
  {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.61.28.28"
  }],
  "version" : "1.0.0",
  "name" : "ECQMUpdate2024Release",
  "title" : "eCQM Update 2024 - Release",
  "status" : "active",
  "experimental" : true,
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/library-type",
      "code" : "asset-collection"
    }]
  },
  "date" : "2024-09-23",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cqi"
    }]
  }],
  "description" : "This library is an example release of a version manifest (also referred to as an expansion profile) that specifies expansion rules for a set of value sets used for an example set of EP/EC measures.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001"
    }]
  }],
  "purpose" : "This library is defined to illustrate a Version Manifest in release status, as it would look as part of the final publication an eCQM Annual Update cycle, approved on April 23rd, 2024, and published on May 2nd, 2024. The versions of code systems and value sets used by the measures is specified in the dependency references to provide stability for value set expansion for any use of the published content. Terminology.HL7.org, in particular, was version 5.5.0 at the time, and FHIR code system versions are chosen from that release.",
  "approvalDate" : "2024-04-23",
  "lastReviewDate" : "2024-04-23",
  "relatedArtifact" : [{
    "type" : "composed-of",
    "display" : "EXM55 - Median Emergency Department Visit Duration, 5.0.0",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR|5.0.0"
  },
  {
    "type" : "composed-of",
    "display" : "EXM108 - Venous Thromboembolism Prophylaxis, 8.2.000",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM108-FHIR|8.2.000"
  },
  {
    "type" : "composed-of",
    "display" : "EXM124 - Cervical Cancer Screening, 9.0.000",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM124-FHIR|9.0.000"
  },
  {
    "type" : "composed-of",
    "display" : "EXM125 - Breast Cancer Screening, 8.0.000",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM125-FHIR|8.0.000"
  },
  {
    "type" : "composed-of",
    "display" : "EXM130 - Colorectal Cancer Screening Measure, 8.0.000",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM130-FHIR|8.0.000"
  },
  {
    "type" : "composed-of",
    "display" : "EXM146 - Appropriate Testing for Children with Pharyngitis, 4.0.0",
    "resource" : "http://hl7.org/fhir/uv/cqm/Measure/EXM146-FHIR|4.0.0"
  },
  {
    "type" : "depends-on",
    "resource" : "http://hl7.org/fhir/uv/cqm/Library/Common|2.0.000"
  },
  {
    "type" : "depends-on",
    "resource" : "http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.0"
  },
  {
    "type" : "depends-on",
    "resource" : "http://hl7.org/fhir/uv/cqm/Library/TJCOverall|4.0.000"
  },
  {
    "type" : "depends-on",
    "resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
  },
  {
    "type" : "depends-on",
    "resource" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category"
  },
  {
    "type" : "depends-on",
    "resource" : "http://hl7.org/fhir/administrative-gender"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62|20210409"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473|20220212"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93|20230117"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52|20220219"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424|20210220"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247|20210220"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45|20210220"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143|20210611"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292|20210611"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87|20210611"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308|20210220"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309|20210611"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209|20210220"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207|20210611"
  },
  {
    "type" : "depends-on",
    "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591|20221118"
  }]
}

```
