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

## Measure: EXM125 - Breast Cancer Screening (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Measure/EXM125-FHIR | Version: 8.0.000 | Highlight text changes?
Standards status: Informative Active as of 2025-08-13 | Computable Name: EXM125
Other Identifiers: http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms#125 (use: official, ), http://example.org/fhir/cqi/ecqm/Measure/Identifier/mips#112 (use: official, ), OID:2.16.840.1.113883.4.642.40.61.29.5
Usage: Clinical Venue: EC
Copyright/Legal: 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. 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. 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. 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.

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

Metadata
Title | EXM125 - Breast Cancer Screening
Version | 8.0.000
Identifier | 125
Identifier | 112
Identifier | urn:oid:2.16.840.1.113883.4.642.40.61.29.5
Effective Period | 2018-01-01 through 2018-12-31
Approval Date | 2016-01-01
Last Review Date | 2016-09-01
Experimental | true
Use Context | Clinical Venue = EC
Jurisdiction | 001 from http://unstats.un.org/unsd/methods/m49/m49.htm
Topic | Health Quality Measure Document
Steward (Publisher) | HL7 International / Clinical Quality Information
Description | Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Purpose | This measure has been developed to support improvement in clinical care.
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. 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. 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. 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.
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.
Measure Basis | boolean
Measure Scoring | Proportion
Improvement Notation | Increased score indicates improvement
Measure Type | process from http://terminology.hl7.org/CodeSystem/measure-type
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). 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). 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).
Clinical Recommendation Statement | 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). U.S. Preventive Services Task Force (2009) Grade: B recommendation. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. 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. 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. Grade: D recommendation. The USPSTF recommends against teaching breast self-examination (BSE). 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. 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.
Measure Group (Rate) (ID: primary)
Stratifier | None
Supplemental Data Guidance | None
Risk Adjustment Factor Guidance | None
Supplemental Data Elements
Supplemental Data Element | Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Ethnicity
Supplemental Data Element | Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Payer
Supplemental Data Element | Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Race
Supplemental Data Element | Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Sex
Measure Logic
Primary Library | EXM125 - Breast Cancer Screening Library
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements Parameters
Population Criteria
Measure Group (Rate) (ID: primary)
Stratifier | None
Logic Definitions
Logic Definition | Library Name: AdultOutpatientEncounters
    define "Qualifying Encounters":
      ([Encounter: "Office Visit"]
        union [Encounter: "Annual Wellness Visit"]
        union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
        union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
        union [Encounter: "Home Healthcare Services"]
      ) ValidEncounter
        where ValidEncounter.period during "Measurement Period"
          and ValidEncounter.status  = 'finished'
Logic Definition | Library Name: Hospice
    define "Has Hospice":
    	exists (
        [Encounter: "Encounter Inpatient"] DischargeHospice
    			where DischargeHospice.status = 'finished'
    		    and (
    	        DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
    				    or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
    	    	)
    				and DischargeHospice.period ends during "Measurement Period"
    	)
        or exists (
          [ServiceRequest: "Hospice care ambulatory"] HospiceOrder
            where HospiceOrder.intent = 'order'
                and HospiceOrder.authoredOn in "Measurement Period"
        )
        or exists (
          [Procedure: "Hospice care ambulatory"] HospicePerformed
            where HospicePerformed.status = 'completed'
              and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
        )
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Sex":
      case
          when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
          when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
          else null
        end
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Payer":
      [Coverage: type in "Payer"] Payer
            return {
              code: Payer.type,
              period: Payer.period
            }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Ethnicity":
      (flatten (
          Patient.extension Extension
            where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
              return Extension.extension
        )) E
          where E.url = 'ombCategory'
            or E.url = 'detailed'
          return E.value as Coding
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Race":
      (flatten (
          Patient.extension Extension
            where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
              return Extension.extension
        )) E
          where E.url = 'ombCategory'
            or E.url = 'detailed'
          return E.value as Coding
Logic Definition | Library Name: EXM125
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: EXM125
    define "Numerator":
    		exists (
    				[DiagnosticReport: "Mammography"] Mammogram
    						where ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less before day of end of "Measurement Period" )
    								and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }
    		)
Logic Definition | Library Name: EXM125
    define "Initial Population":
    		Patient.gender = 'female'
    				and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[51, 74]
    				and exists AdultOutpatientEncounters."Qualifying Encounters"
Logic Definition | Library Name: EXM125
    define "Denominator":
    		"Initial Population"
Logic Definition | Library Name: EXM125
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: EXM125
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: EXM125
    define "Unilateral Mastectomy Procedure":
    		[Procedure: "Unilateral Mastectomy"] UnilateralMastectomyProcedure
    				where Global."Normalize Interval"(UnilateralMastectomyProcedure.performed) ends before day of end of "Measurement Period"
    						and UnilateralMastectomyProcedure.status = 'completed'
Logic Definition | Library Name: EXM125
    define "Right Mastectomy":
    		(
    				( [Condition: "Status Post Right Mastectomy"] C
              where C.clinicalStatus ~ ToConcept(Global."active")
            )
    				union (
    						[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
    								where UnilateralMastectomyDiagnosis.bodySite in "Right"
                      and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")
    				)
    		) RightMastectomy
    				where Global."Normalize Interval"(RightMastectomy.onset) starts before day of end of "Measurement Period"
Logic Definition | Library Name: EXM125
    define "Left Mastectomy":
    		(
    		    ( [Condition: "Status Post Left Mastectomy"] C
              where C.clinicalStatus ~ ToConcept(Global."active")
            )
    				union (
    						[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
    								where UnilateralMastectomyDiagnosis.bodySite in "Left"
                      and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")
    				)
    		) LeftMastectomy
    				where Global."Normalize Interval"(LeftMastectomy.onset) starts before day of end of "Measurement Period"
Logic Definition | Library Name: EXM125
    define "History Bilateral Mastectomy":
    		[Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory
    				where Global."Normalize Interval"(BilateralMastectomyHistory.onset) starts before day of end of "Measurement Period"
              and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global."active")
Logic Definition | Library Name: EXM125
    define "Bilateral Mastectomy Procedure":
    		[Procedure: "Bilateral Mastectomy"] BilateralMastectomyPerformed
    				where Global."Normalize Interval"(BilateralMastectomyPerformed.performed) ends before day of end of "Measurement Period"
    						and BilateralMastectomyPerformed.status = 'completed'
Logic Definition | Library Name: EXM125
    define "Denominator Exclusion":
    		Hospice."Has Hospice"
    				or ( Count("Unilateral Mastectomy Procedure") = 2 )
    				or ( exists "Right Mastectomy" and exists "Left Mastectomy" )
    				or exists "History Bilateral Mastectomy"
    				or exists "Bilateral Mastectomy Procedure"
Logic Definition | Library Name: EXM125
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: MATGlobalCommonFunctions
    /*
    *
    *    CQFMeasures Common Logic
    *
    */

    define function "Normalize Interval"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):
      case
    	  when choice is FHIR.dateTime then
        	Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]
    		when choice is FHIR.Period then
      		FHIRHelpers.ToInterval(choice as FHIR.Period)
    		when choice is FHIR.instant then
    			Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]
    		when choice is FHIR.Age then
    		  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),
    			  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)
    		when choice is FHIR.Range then
    		  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),
    			  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)
    		when choice is FHIR.Timing then
    		  Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type')
        when choice is FHIR.string then
          Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value')
    		else
    			null as Interval<DateTime>
    	end
Logic Definition | Library Name: MATGlobalCommonFunctions
    define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime):
    	years between ToDate(BirthDateTime)and ToDate(AsOf)
Logic Definition | Library Name: MATGlobalCommonFunctions
    define function "ToDate"(Value DateTime):
    	DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value AdministrativeGender): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToDateTime(value dateTime): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
    value to a CQL DateTime Interval
    @comment: If the start value of the given period is unspecified, the starting
    boundary of the resulting interval will be open (meaning the start of the interval
    is unknown, as opposed to interpreted as the beginning of time).
    */
    define function ToInterval(period FHIR.Period):
        if period is null then
            null
        else
            if period."start" is null then
                Interval(period."start".value, period."end".value]
            else
                Interval[period."start".value, period."end".value]
Logic Definition | Library Name: FHIRHelpers
    define function ToDateTime(value instant): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToDate(value date): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity)
    value to a CQL Quantity
    @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity
    has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)
    an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.
    @seealso: ToCalendarUnit
    */
    define function ToQuantity(quantity FHIR.Quantity):
        case
            when quantity is null then null
            when quantity.value is null then null
            when quantity.comparator is not null then
                Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
            when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
                  or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
                System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
            else
                Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')
        end
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts a UCUM definite duration unit to a CQL calendar duration
    unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities)
    topic of the CQL specification.
    @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate
    */
    define function ToCalendarUnit(unit System.String):
        case unit
            when 'ms' then 'millisecond'
            when 's' then 'second'
            when 'min' then 'minute'
            when 'h' then 'hour'
            when 'd' then 'day'
            when 'wk' then 'week'
            when 'mo' then 'month'
            when 'a' then 'year'
            else unit
        end
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value DiagnosticReportStatus): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value EncounterStatus): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
    */
    define function ToConcept(concept FHIR.CodeableConcept):
        if concept is null then
            null
        else
            System.Concept {
                codes: concept.coding C return ToCode(C),
                display: concept.text.value
            }
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
    */
    define function ToCode(coding FHIR.Coding):
        if coding is null then
            null
        else
            System.Code {
              code: coding.code.value,
              system: coding.system.value,
              version: coding.version.value,
              display: coding.display.value
            }
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value ServiceRequestIntent): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value ProcedureStatus): value.value
Terminology
Code System | Description: Code system SNOMEDCT:2017-09 Resource: `http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709` Canonical URL: `http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709`
Code System | Description: Code system ConditionClinicalStatusCodes Resource: Condition Clinical Status Codes Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Value Set | Description: Value set Mammography Resource: Mammography Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018`
Value Set | 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`
Value Set | 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`
Value Set | 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`
Value Set | 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`
Value Set | 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`
Value Set | Description: Value set Payer Resource: Payer Type Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591`
Value Set | 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`
Value Set | 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`
Value Set | Description: Value set Unilateral Mastectomy Resource: Unilateral Mastectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020`
Value Set | Description: Value set Status Post Right Mastectomy Resource: Status Post Right Mastectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070`
Value Set | Description: Value set Unilateral Mastectomy, Unspecified Laterality Resource: Unilateral Mastectomy, Unspecified Laterality Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071`
Value Set | Description: Value set Right Resource: Right Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035`
Value Set | Description: Value set Status Post Left Mastectomy Resource: Status Post Left Mastectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069`
Value Set | Description: Value set Left Resource: Left Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036`
Value Set | Description: Value set History of bilateral mastectomy Resource: History of bilateral mastectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068`
Value Set | Description: Value set Bilateral Mastectomy Resource: Bilateral Mastectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005`
Direct Reference Code | Display: Discharge to home for hospice care (procedure) Code: 428361000124107 System: `http://snomed.info/sct`
Direct Reference Code | Display: Discharge to healthcare facility for hospice care (procedure) Code: 428371000124100 System: `http://snomed.info/sct`
Direct Reference Code | Code: active System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Dependencies
Dependency | Description: FHIR model information Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 Canonical URL: `http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|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 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 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`
Data Requirements
Data Requirement | Type: Patient Profile(s): Patient Must Support Elements: url, extension, value
Data Requirement | Type: DiagnosticReport Profile(s): DiagnosticReport Must Support Elements: code, effective, status Code Filter(s): Path: code ValueSet: Mammography
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status Code Filter(s): Path: type ValueSet: Office Visit
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status Code Filter(s): Path: type ValueSet: Annual Wellness Visit
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status Code Filter(s): Path: type ValueSet: Preventive Care Services Established Office Visit, 18 and Up
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status Code Filter(s): Path: type ValueSet: Preventive Care Services Initial Office Visit, 18 and Up
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status Code Filter(s): Path: type ValueSet: Home Healthcare Services
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, status, hospitalization, hospitalization.dischargeDisposition, period Code Filter(s): Path: type ValueSet: Encounter Inpatient
Data Requirement | Type: Coverage Profile(s): Coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type
Data Requirement | Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, intent, authoredOn Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory
Data Requirement | Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory
Data Requirement | Type: Procedure Profile(s): Procedure Must Support Elements: code, performed, status Code Filter(s): Path: code ValueSet: Unilateral Mastectomy
Data Requirement | Type: Procedure Profile(s): Procedure Must Support Elements: code, performed, status Code Filter(s): Path: code ValueSet: Bilateral Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Status Post Right Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Status Post Left Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, bodySite, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Unilateral Mastectomy, Unspecified Laterality
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, onset, clinicalStatus Code Filter(s): Path: code ValueSet: History of bilateral mastectomy
Parameters
Name | Use | Card. | Type | Documentation
Measurement Period | In | 0..1 | Period |
SDE Sex | Out | 0..1 | Coding |
Numerator | Out | 0..1 | boolean |
Denominator | Out | 0..1 | boolean |
SDE Payer | Out | 0..* | Resource |
Initial Population | Out | 0..1 | boolean |
SDE Ethnicity | Out | 0..* | Coding |
Denominator Exclusion | Out | 0..1 | boolean |
SDE Race | Out | 0..* | Coding |
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