CervicalCancerScreeningFHIR.json

{
  "resourceType": "Measure",
  "id": "CervicalCancerScreeningFHIR",
  "meta": {
    "profile": [ "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm", "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm", "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm" ]
  },
  "contained": [ {
    "resourceType": "Library",
    "id": "effective-data-requirements",
    "extension": [ {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding": {
        "system": "http://terminology.hl7.org/CodeSystem/observation-category",
        "code": "laboratory",
        "display": "laboratory"
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding": {
        "system": "http://snomed.info/sct",
        "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",
        "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/observation-category",
        "code": "survey",
        "display": "survey"
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding": {
        "system": "http://snomed.info/sct",
        "code": "373066001",
        "display": "Yes (qualifier value)"
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding": {
        "system": "http://loinc.org",
        "code": "45755-6",
        "display": "Hospice care [Minimum Data Set]"
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding": {
        "system": "http://loinc.org",
        "code": "71007-9",
        "display": "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Cervical Cytology Within 3 Years"
      }, {
        "url": "statement",
        "valueString": "define \"Cervical Cytology Within 3 Years\":\n  ( ( [Observation: \"Pap Test\"] ).isLaboratoryTestPerformed ( ) ) CervicalCytology\n    where CervicalCytology.effective.latest ( ) during day of Interval[start of \"Measurement Period\" - 2 years, end of \"Measurement Period\"]\n      and CervicalCytology.value is not null"
      }, {
        "url": "displaySequence",
        "valueInteger": 0
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "HPV Test Within 5 Years for Women Age 30 and Older"
      }, {
        "url": "statement",
        "valueString": "define \"HPV Test Within 5 Years for Women Age 30 and Older\":\n  ( ( [Observation: \"HPV Test\"] ).isLaboratoryTestPerformed ( ) ) HPVTest\n    where AgeInYearsAt(date from HPVTest.effective.latest()) >= 30\n      and HPVTest.effective.latest ( ) during day of Interval[start of \"Measurement Period\" - 4 years, end of \"Measurement Period\"]\n      and HPVTest.value is not null"
      }, {
        "url": "displaySequence",
        "valueInteger": 1
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Numerator"
      }, {
        "url": "statement",
        "valueString": "define \"Numerator\":\n  exists \"Cervical Cytology Within 3 Years\"\n    or exists \"HPV Test Within 5 Years for Women Age 30 and Older\""
      }, {
        "url": "displaySequence",
        "valueInteger": 2
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Qualifying Encounters"
      }, {
        "url": "statement",
        "valueString": "define \"Qualifying Encounters\":\n  ( ( [\"Encounter\": \"Office Visit\"]\n      union [Encounter: \"Preventive Care Services Established Office Visit, 18 and Up\"]\n      union [Encounter: \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n      union [Encounter: \"Home Healthcare Services\"]\n      union [Encounter: \"Telephone Visits\"]\n      union [Encounter: \"Virtual Encounter\"]\n  ).isEncounterPerformed ( ) ) ValidEncounters\n    where ValidEncounters.period.toInterval ( ) during day of \"Measurement Period\""
      }, {
        "url": "displaySequence",
        "valueInteger": 3
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Initial Population"
      }, {
        "url": "statement",
        "valueString": "define \"Initial Population\":\n  AgeInYearsAt(date from \n    end of \"Measurement Period\"\n  ) in Interval[24, 64]\n    and Patient.gender = 'female'\n    and exists \"Qualifying Encounters\""
      }, {
        "url": "displaySequence",
        "valueInteger": 4
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Denominator"
      }, {
        "url": "statement",
        "valueString": "define \"Denominator\":\n  \"Initial Population\""
      }, {
        "url": "displaySequence",
        "valueInteger": 5
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Hospice"
      }, {
        "url": "name",
        "valueString": "Has Hospice Services"
      }, {
        "url": "statement",
        "valueString": "define \"Has Hospice Services\":\n  exists ((([Encounter: \"Encounter Inpatient\"]).isEncounterPerformed()) InpatientEncounter\n      where (InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n          or InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n      )\n        and InpatientEncounter.period.toInterval() ends during day of \"Measurement Period\"\n  )\n    or exists ((([Encounter: \"Hospice Encounter\"]).isEncounterPerformed()) HospiceEncounter\n        where HospiceEncounter.period.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([Observation: \"Hospice care [Minimum Data Set]\"]).isAssessmentPerformed()) HospiceAssessment\n        where HospiceAssessment.value ~ \"Yes (qualifier value)\"\n          and HospiceAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([ServiceRequest: \"Hospice Care Ambulatory\"]).isInterventionOrder()) HospiceOrder\n        where HospiceOrder.authoredOn.toInterval() during day of \"Measurement Period\"\n        // and HospiceOrder.doNotPerform is not true\n        // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447\n    )\n    or exists ((([Procedure: \"Hospice Care Ambulatory\"]).isInterventionPerformed()) HospicePerformed\n        where HospicePerformed.performed.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists (([Condition: \"Hospice Diagnosis\"]) HospiceCareDiagnosis\n        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n    )"
      }, {
        "url": "displaySequence",
        "valueInteger": 6
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Absence of Cervix"
      }, {
        "url": "statement",
        "valueString": "define \"Absence of Cervix\":\n  ( ( ( [Procedure: \"Hysterectomy with No Residual Cervix\"] ).isProcedurePerformed ( ) ) NoCervixProcedure\n      where NoCervixProcedure.performed.toInterval ( ) ends on or before end of \"Measurement Period\"\n  )\n    union ( [Condition: \"Congenital or Acquired Absence of Cervix\"] NoCervixDiagnosis\n        where NoCervixDiagnosis.prevalenceInterval ( ) starts on or before end of \"Measurement Period\"\n    )"
      }, {
        "url": "displaySequence",
        "valueInteger": 7
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "PalliativeCare"
      }, {
        "url": "name",
        "valueString": "Has Palliative Care in the Measurement Period"
      }, {
        "url": "statement",
        "valueString": "define \"Has Palliative Care in the Measurement Period\":\n  exists ((([Observation: \"Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)\"]).isAssessmentPerformed()) PalliativeAssessment\n      where PalliativeAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n  )\n    or exists ([Condition: \"Palliative Care Diagnosis\"] PalliativeDiagnosis\n        where PalliativeDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([Encounter: \"Palliative Care Encounter\"]).isEncounterPerformed()) PalliativeEncounter\n        where PalliativeEncounter.period.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([Procedure: \"Palliative Care Intervention\"]).isInterventionPerformed()) PalliativeIntervention\n        where PalliativeIntervention.performed.toInterval() overlaps day of \"Measurement Period\"\n    )"
      }, {
        "url": "displaySequence",
        "valueInteger": 8
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "CervicalCancerScreeningFHIR"
      }, {
        "url": "name",
        "valueString": "Denominator Exclusions"
      }, {
        "url": "statement",
        "valueString": "define \"Denominator Exclusions\":\n  Hospice.\"Has Hospice Services\"\n    or exists \"Absence of Cervix\"\n    or PalliativeCare.\"Has Palliative Care in the Measurement Period\""
      }, {
        "url": "displaySequence",
        "valueInteger": 9
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isLaboratoryTestPerformed"
      }, {
        "url": "statement",
        "valueString": "//Laboratory Test, Performed\ndefine fluent function isLaboratoryTestPerformed(Obs List<Observation>):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }\n      and exists ( O.category ObservationCategory\n          where ( ObservationCategory ) ~ \"laboratory\"\n      )"
      }, {
        "url": "displaySequence",
        "valueInteger": 10
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "FHIRHelpers"
      }, {
        "url": "name",
        "valueString": "ToConcept"
      }, {
        "url": "statement",
        "valueString": "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
      }, {
        "url": "displaySequence",
        "valueInteger": 11
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "QICoreCommon"
      }, {
        "url": "name",
        "valueString": "latest"
      }, {
        "url": "statement",
        "valueString": "/*\n@description: Given an interval, returns the ending point if the interval has an ending boundary specified,\notherwise, returns the starting point\n*/\ndefine fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n  (choice.toInterval()) period\n    return\n      if (period.\"hasEnd\"()) then end of period\n      else start of period"
      }, {
        "url": "displaySequence",
        "valueInteger": 12
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isEncounterPerformed"
      }, {
        "url": "statement",
        "valueString": "//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List<Encounter>):\n  Enc E\n    where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}"
      }, {
        "url": "displaySequence",
        "valueInteger": 13
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "QICoreCommon"
      }, {
        "url": "name",
        "valueString": "toInterval"
      }, {
        "url": "statement",
        "valueString": "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n  \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
      }, {
        "url": "displaySequence",
        "valueInteger": 14
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isAssessmentPerformed"
      }, {
        "url": "statement",
        "valueString": "//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.\n\n//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List<Observation>):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }\n          and exists ( O.category ObservationCategory\n          where ( ObservationCategory ) ~ \"survey\"\n      )"
      }, {
        "url": "displaySequence",
        "valueInteger": 15
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isInterventionOrder"
      }, {
        "url": "statement",
        "valueString": "//Intervention, Order: active and completed only    \ndefine fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):\n  ServiceRequest S\n    where S.status in { 'active', 'completed' }\n      and S.intent = 'order'"
      }, {
        "url": "displaySequence",
        "valueInteger": 16
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isInterventionPerformed"
      }, {
        "url": "statement",
        "valueString": "//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List<Procedure>):\n  Proc P\n    where P.status ~ 'completed'"
      }, {
        "url": "displaySequence",
        "valueInteger": 17
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "QICoreCommon"
      }, {
        "url": "name",
        "valueString": "prevalenceInterval"
      }, {
        "url": "statement",
        "valueString": "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n  or condition.clinicalStatus ~ \"recurrence\"\n  or condition.clinicalStatus ~ \"relapse\" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n    (end of condition.abatementInterval()) abatementDate\n    return if abatementDate is null then\n      Interval[start of condition.onset.toInterval(), abatementDate)\n    else\n      Interval[start of condition.onset.toInterval(), abatementDate]"
      }, {
        "url": "displaySequence",
        "valueInteger": 18
      } ]
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition",
      "extension": [ {
        "url": "libraryName",
        "valueString": "Status"
      }, {
        "url": "name",
        "valueString": "isProcedurePerformed"
      }, {
        "url": "statement",
        "valueString": "//Procedure, Performed\ndefine fluent function isProcedurePerformed(Proc List<Procedure>):\n  Proc P\n    where P.status ~ 'completed'"
      }, {
        "url": "displaySequence",
        "valueInteger": 19
      } ]
    } ],
    "name": "EffectiveDataRequirements",
    "status": "active",
    "type": {
      "coding": [ {
        "system": "http://terminology.hl7.org/CodeSystem/library-type",
        "code": "module-definition"
      } ]
    },
    "relatedArtifact": [ {
      "type": "depends-on",
      "display": "Library Status",
      "resource": "Library/Status|1.8.000"
    }, {
      "type": "depends-on",
      "display": "Library FHIRHelpers",
      "resource": "Library/FHIRHelpers|4.4.000"
    }, {
      "type": "depends-on",
      "display": "Library QICoreCommon",
      "resource": "Library/QICoreCommon|2.1.000"
    }, {
      "type": "depends-on",
      "display": "Library Hospice",
      "resource": "Library/Hospice|6.12.000"
    }, {
      "type": "depends-on",
      "display": "Library PalliativeCare",
      "resource": "Library/PalliativeCare|1.11.000"
    }, {
      "type": "depends-on",
      "display": "Code system ObservationCategoryCodes",
      "resource": "http://terminology.hl7.org/CodeSystem/observation-category"
    }, {
      "type": "depends-on",
      "display": "Code system SNOMEDCT",
      "resource": "http://snomed.info/sct"
    }, {
      "type": "depends-on",
      "display": "Code system LOINC",
      "resource": "http://loinc.org"
    }, {
      "type": "depends-on",
      "display": "Value set Pap Test",
      "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"
    }, {
      "type": "depends-on",
      "display": "Value set HPV Test",
      "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"
    }, {
      "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 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 Telephone Visits",
      "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"
    }, {
      "type": "depends-on",
      "display": "Value set Virtual Encounter",
      "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"
    }, {
      "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 Encounter",
      "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"
    }, {
      "type": "depends-on",
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    "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
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      "reference": "Device/cqf-tooling"
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  "url": "https://madie.cms.gov/Measure/CervicalCancerScreeningFHIR",
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    "use": "usual",
    "type": {
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        "code": "short-name"
      } ]
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    "value": "CMS124FHIR"
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    "system": "https://madie.cms.gov/measure/cmsId",
    "value": "124FHIR",
    "assigner": {
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  "version": "0.0.001",
  "name": "CervicalCancerScreeningFHIR",
  "title": "Cervical Cancer ScreeningFHIR",
  "status": "draft",
  "experimental": false,
  "date": "2024-07-09T14:53:56+00:00",
  "publisher": "National Committee for Quality Assurance",
  "contact": [ {
    "telecom": [ {
      "system": "url",
      "value": "https://www.ncqa.org/"
    } ]
  } ],
  "description": "Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed within the last 3 years - Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years",
  "purpose": "UNKNOWN",
  "usage": "To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.  Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria.  Evidence of hrHPV testing within the last 5 years also captures patients who had cotesting; therefore additional methods to identify cotesting are not necessary.  This eCQM is a patient-based measure.  This FHIR-based measure has been derived from the QDM-based measure: CMS124v13.  Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
  "copyright": "This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2021 National Committee for Quality Assurance. All Rights Reserved.  Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications.  CPT(R) contained in the Measure specifications is copyright 2004-2021 American Medical Association. LOINC(R) copyright 2004-2021 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2021 International Health Terminology Standards Development Organisation. ICD-10 copyright 2021 World Health Organization. All Rights Reserved.",
  "effectivePeriod": {
    "start": "2025-01-01",
    "end": "2025-12-31"
  },
  "author": [ {
    "name": "National Committee for Quality Assurance",
    "telecom": [ {
      "system": "url",
      "value": "https://www.ncqa.org/"
    } ]
  } ],
  "library": [ "https://madie.cms.gov/Library/CervicalCancerScreeningFHIR" ],
  "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.   Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
  "rationale": "All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).",
  "clinicalRecommendationStatement": "US Preventive Services Task Force (USPSTF) (2018) \"The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) (A recommendation)\"  \"The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. (D recommendation)\"  \"The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation)\"  \"The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion (ie, cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer. (D recommendation)\"",
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          "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
          "code": "proportion",
          "display": "Proportion"
        } ]
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode": "boolean"
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process",
          "display": "Process"
        } ]
      }
    }, {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
      "valueCode": "None"
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    "population": [ {
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      "code": {
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          "code": "initial-population",
          "display": "Initial Population"
        } ]
      },
      "description": "Women 24-64 years of age by the end of the measurement period with a visit during the measurement period",
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "Initial Population"
      }
    }, {
      "id": "C02AA51E-4436-4034-A67F-DB42C22EB337",
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          "display": "Denominator"
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    }, {
      "id": "2EF6ABDF-E416-44B8-928B-DCC7D7C55860",
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          "code": "denominator-exclusion",
          "display": "Denominator Exclusion"
        } ]
      },
      "description": "Exclude patients who are in hospice care for any part of the measurement period.  Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.  Exclude patients receiving palliative care for any part of the measurement period.",
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      },
      "description": "Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria: - Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test.  - Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.",
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}