Back to top
Top
CMS Measure ID:
Version:
2
NQF Number:
0
Performance/Reporting Period
2020
Description:

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Data Elements contained within the eCQM + Expand all

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a patient's number of alcoholic drinks per drinking day.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Assessment, Performed.
Inclusion Criteria: Includes only relevant concepts associated with identifying a quantitative observation of the reported number of alcoholic drinks per drinking day. This is a grouping of a LOINC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: Average Number of Drinks per Drinking Day value set (2.16.840.1.113883.3.464.1003.106.12.1018)

QDM Datatype and Definition (QDM Version 5.4)

Assessment, Performed

Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The time the assessment is completed; Author dateTime.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a family history of fracture in a parent.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Assessment, Performed.
Inclusion Criteria: Includes only relevant concepts associated with a patient has a family history of fracture in a parent. This is a grouping of SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: History of hip fracture in parent value set (2.16.840.1.113883.3.464.1003.113.12.1040)

QDM Datatype and Definition (QDM Version 5.4)

Assessment, Performed

Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The time the assessment is completed; Author dateTime.

Direct Reference Code

Constrained to 'Major osteoporotic fracture 10-year probability [Likelihood] Fracture Risk Assessment' LOINC code

QDM Datatype and Definition (QDM Version 5.4)

Assessment, Performed

Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The time the assessment is completed; Author dateTime.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent screening for tobacco use.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Assessment.
Inclusion Criteria: Includes only relevant concepts associated with screening tools or questions used to obtain a patient's tobacco use status.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: Tobacco Use Screening value set (2.16.840.1.113883.3.526.3.1278)

QDM Datatype and Definition (QDM Version 5.4)

Assessment, Performed

Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The time the assessment is completed; Author dateTime.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of ankylosing spondylitis.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with ankylosing spondylitis with comorbidities and associated system involvement. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes all diagnosis codes associated with juvenile ankylosing spondylitis.

Constrained to codes in the Diagnosis: Ankylosing Spondylitis value set (2.16.840.1.113883.3.464.1003.113.12.1045)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of chronic liver disease.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for chronic liver disease or cirrhosis, liver abscess or sequelae of chronic liver disease and other disorders of the liver. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Chronic Liver Disease value set (2.16.840.1.113883.3.464.1003.199.12.1035)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of chronic malnutrition.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for specified and unspecified eating disorders. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes all diagnosis codes for feeding disorders of infancy or childhood. These include feeding disturbances, developmental delays, loss of appetite and rumination. Also excludes restrictive food intake disorders and pica.

Constrained to codes in the Diagnosis: Chronic Malnutrition value set (2.16.840.1.113883.3.464.1003.199.12.1036)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of Cushing's syndrome.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis of Cushing's syndrome, including codes for drug-induced Cushing's syndrome, ectopic Adrenocorticotropic hormone (ACTH) syndrome and unspecified Cushing's syndrome. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Cushings Syndrome value set (2.16.840.1.113883.3.464.1003.117.12.1009)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of Ehlers-Danlos syndrome.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for Ehlers-Danlos syndrome. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Ehlers Danlos Syndrome value set (2.16.840.1.113883.3.464.1003.113.12.1047)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of end stage renal disease.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with a diagnosis of end stage renal disease.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: End Stage Renal Disease value set (2.16.840.1.113883.3.526.3.353)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of hyperparathyroidism.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes associated with hyperparathyroidism, including primary, secondary, tertiary, and all other types of hyperparathyroidism. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnoses of autonomous thyroid function, Iatrogenic thyrotoxicosis factitia, neonatal thyrotoxicosis and thyrotoxic crisis.

Constrained to codes in the Diagnosis: Hyperparathyroidism value set (2.16.840.1.113883.3.464.1003.117.12.1016)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of hyperthyroidism.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with all diagnosis codes for thyrotoxicosis, both with and without thyrotoxic crisis or storm, and with and without presence of goiter. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnosis codes for neonatal thyrotoxicosis.

Constrained to codes in the Diagnosis: Hyperthyroidism value set (2.16.840.1.113883.3.464.1003.117.12.1015)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of lupus (lupus erythematosus).
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for systemic, discoid, and drug-induced systemic lupus erythematosus. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Lupus value set (2.16.840.1.113883.3.464.1003.117.12.1010)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of chronic intestinal malabsorption.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for regional enteritis, ulcerative enterocolitis, celiac disease, tropical sprue, blind loop syndrome, pancreatic steatorrhea, and other specified or unspecified intestinal malabsorption disorders. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnoses of specified disorders of the intestine, including fistula of intestine, ulceration of intestine, perforation of intestine, angiodysplasia (with or without hemorrhage), dieulafoy lesion, and vomiting of fecal matter.

Constrained to codes in the Diagnosis: Malabsorption Syndromes value set (2.16.840.1.113883.3.464.1003.199.12.1050)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of Marfan's syndrome.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for Marfan's syndrome with or without cardiovascular, ocular, skeletal, or epithelial manifestations. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Marfan's Syndrome value set (2.16.840.1.113883.3.464.1003.113.12.1048)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of osteogenesis imperfecta.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for osteogenesis imperfecta disease classifications 1-4. Includes only relevant concepts associated with diagnoses in perinatal population. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnosis of osteoporosis with pseudoglioma.

Constrained to codes in the Diagnosis: Osteogenesis Imperfecta value set (2.16.840.1.113883.3.464.1003.113.12.1044)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of osteopenia.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for specified and unspecified disorders of bones and cartilage. Includes only relevant concepts associated with osteopenia of prematurity, drug-induced osteopenia, and senile osteopenia. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnosis of arrest of bone development or growth, chondromalacia, or stress fracture of bone.

Constrained to codes in the Diagnosis: Osteopenia value set (2.16.840.1.113883.3.464.1003.113.12.1049)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of osteoporosis.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for idiopathic, senile, disuse, and other/unspecified osteoporosis. Includes only relevant concepts associated with localized, transient, and regional migrating osteoporosis. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnosis codes for osteoporosis due to cystic fibrosis.

Constrained to codes in the Diagnosis: Osteoporosis value set (2.16.840.1.113883.3.464.1003.113.12.1038)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent codes that are used to identify patients with a diagnosis of osteoporotic fracture.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes associated with osteoporotic fracture. This is a grouping of ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Osteoporotic Fractures value set (2.16.840.1.113883.3.464.1003.113.12.1050)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of psoriatic arthritis.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with psoriatic arthritis, arthritis mutilans, psoriatic spondylitis, and other unspecified psoriatic arthropathy. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes diagnosis codes for juvenile psoriatic arthritis and dactylitis.

Constrained to codes in the Diagnosis: Psoriatic Arthritis value set (2.16.840.1.113883.3.464.1003.113.12.1046)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of rheumatoid arthritis.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with rheumatoid arthritis and Felty's syndrome. Includes only relevant concepts associated with comorbidities occurring with rheumatoid arthritis, such as rheumatoid polyneuropathy, rheumatoid myopathy, rheumatoid heart disease, rheumatoid vasculitis, and rheumatoid lung disease. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes codes for juvenile chronic polyarthritis, chronic post rheumatic arthropathy, and inflammatory polyarthropathy.

Constrained to codes in the Diagnosis: Rheumatoid Arthritis value set (2.16.840.1.113883.3.464.1003.113.12.1005)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a diagnosis of type 1 diabetes mellitus and is distinguished from other types of diabetes mellitus, including gestational, drug-induced or type 2 diabetes mellitus.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with diagnosis codes for type 1 diabetes mellitus, with or without reference to complications and comorbidities. This is a grouping of ICD-9-CM, ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes all diagnosis codes associated with gestational, drug-induced and type 2 diabetes mellitus without mention of type 1 diabetes mellitus.

Constrained to codes in the Diagnosis: Type 1 Diabetes value set (2.16.840.1.113883.3.464.1003.103.12.1020)

QDM Datatype and Definition (QDM Version 5.4)

Diagnosis

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a dual-energy x-ray absorptiometry (DXA) scan.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnostic Study.
Inclusion Criteria: Includes only relevant concepts associated with DXA scans of the femur, radius, ulna, lumbar spine, hip, calcaneus and skeletal system. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnostic Study, Order: DXA (Dual energy Xray Absorptiometry) Scan value set (2.16.840.1.113883.3.464.1003.113.12.1051)

QDM Datatype and Definition (QDM Version 5.4)

Diagnostic Study, Order

Data elements that meet criteria using this datatype should document a request by a clinician or appropriately licensed care provider to an appropriate provider or organization to perform the diagnostic study indicated by the QDM category and its corresponding value set. The request may be in the form of a consultation or a direct order to the organization that performs the diagnostic study. Diagnostic studies are those that are not performed in the clinical laboratory. Such studies include but are not limited to imaging studies, cardiology studies (electrocardiogram, treadmill stress testing), pulmonary function testing, vascular laboratory testing, and others.

Timing: The time the order is signed; Author dateTime.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent patients who have had an office or other outpatient visit.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Encounter, Performed.
Inclusion Criteria: Includes only relevant concepts associated with comprehensive history, evaluation, and management of a patient in an office or outpatient facility. Patient can be presenting with problems that are minor to high severity. This is a grouping value set of CPT codes.
Exclusion Criteria: Excludes non-office visits, including telehealth services.

Constrained to codes in the Encounter, Performed: Office Visit 1 value set (2.16.840.1.113883.3.464.1003.101.12.1001)

QDM Datatype and Definition (QDM Version 5.4)

Encounter, Performed

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent patients who have had an outpatient interaction at an office with a member of their medical care team.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Encounter, Performed.
Inclusion Criteria: Includes only relevant concepts associated with comprehensive history, evaluation, and management of a patient in an office or outpatient facility. Patient can be presenting with problems that are minor to high severity. This is a grouping value set of CPT and SNOMED CT codes.
Exclusion Criteria: Excludes non-office visits, including telehealth services.

Constrained to codes in the Encounter, Performed: Outpatient Consultation 1 value set (2.16.840.1.113883.3.464.1003.101.12.1008)

QDM Datatype and Definition (QDM Version 5.4)

Encounter, Performed

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent patients over the age of 18 who have had an established preventive care office visit.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Encounter, Performed.
Inclusion Criteria: Includes only relevant concepts associated with comprehensive preventive medicine reevaluation and management of an individual the age of 18 years or over. This is a grouping value set of CPT codes.
Exclusion Criteria: Excludes non-office visits, including telehealth services.

Constrained to codes in the Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up 1 value set (2.16.840.1.113883.3.464.1003.101.12.1025)

QDM Datatype and Definition (QDM Version 5.4)

Encounter, Performed

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent unlisted preventive medicine services.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Encounter, Performed.
Inclusion Criteria: Includes only relevant concepts associated with unlisted preventive medicine services. This is a grouping of a CPT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Preventive Care Services - Other value set (2.16.840.1.113883.3.464.1003.101.12.1030)

QDM Datatype and Definition (QDM Version 5.4)

Encounter, Performed

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent patients over the age of 18 who have had an initial preventive care office visit.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Encounter, Performed.
Inclusion Criteria: Includes only relevant concepts associated with comprehensive preventive medicine reevaluation and management of an individual the age of 18 years or over. This is a grouping value set of CPT codes.
Exclusion Criteria: Excludes non-office visits, including telehealth services.

Constrained to codes in the Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up value set (2.16.840.1.113883.3.464.1003.101.12.1023)

QDM Datatype and Definition (QDM Version 5.4)

Encounter, Performed

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent aromatase inhibitor medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Active or Medication, Ordered.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable; both steroidal and non-steroidal inhibitors; both non-selective and selective inhibitors; aromatase inhibitors only.
Exclusion Criteria: Excludes branded drugs; components or ingredients only; non-prescribable; aromatase inhibitors in combination with other medications; selective inhibitors vorozole, formestane, and fadrozole.

Constrained to codes in the Medication, Active: Aromatase Inhibitors value set (2.16.840.1.113883.3.464.1003.196.12.1265)

QDM Datatype and Definition (QDM Version 5.4)

Medication, Active

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set is being taken by the patient. Keep in mind that when this datatype is used with timing relationships, the criterion is looking for a medication being taken for the time frame indicated by the timing relationships.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.  

Timing: The Relevant Period addresses:

  • startTime - when the medication is first known to be used (generally the time of entry on the medication list),
  • stopTime - when the medication is discontinued (generally, the time discontinuation is recorded on the medication list)
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent glucocorticoid medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Active.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable; cortisone, dexamethasone, hydrocortisone, prednisone, methyprednisone, triamcinolone, betamethasone, dexamethasone, fludrocortisone and triamcinolone. Includes only relevant concepts associated with only glucocorticoids taken orally, i.e., through an tablet, capsule, or oral solution.
Exclusion Criteria: Excludes branded drugs; components or ingredients only; non-prescribable; glucorticoids in combination with other drugs. Excludes all glucocorticoids taken non-orally, i.e., as a nasal inhalant or injectable solution.

Constrained to codes in the Medication, Active: Glucocorticoids (oral only) value set (2.16.840.1.113883.3.464.1003.196.12.1266)

QDM Datatype and Definition (QDM Version 5.4)

Medication, Active

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set is being taken by the patient. Keep in mind that when this datatype is used with timing relationships, the criterion is looking for a medication being taken for the time frame indicated by the timing relationships.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.  

Timing: The Relevant Period addresses:

  • startTime - when the medication is first known to be used (generally the time of entry on the medication list),
  • stopTime - when the medication is discontinued (generally, the time discontinuation is recorded on the medication list)
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent aromatase inhibitor medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Active or Medication, Ordered.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable; both steroidal and non-steroidal inhibitors; both non-selective and selective inhibitors; aromatase inhibitors only.
Exclusion Criteria: Excludes branded drugs; components or ingredients only; non-prescribable; aromatase inhibitors in combination with other medications; selective inhibitors vorozole, formestane, and fadrozole.

Constrained to codes in the Medication, Order: Aromatase Inhibitors value set (2.16.840.1.113883.3.464.1003.196.12.1265)

QDM Datatype and Definition (QDM Version 5.4)

Medication, Order

Data elements that meet criteria using this datatype should document a request to a pharmacy to provide the medication indicated by the QDM category and its corresponding value set.

Timing: The Author dateTime is the time the order is signed.

Timing: The Relevant Period addresses:

  • startTime - when the first administration of the medication is expected. The first administration may be expected at the time of the order or at a specified future date (i.e., the active time for the order); such information should be identified in the medication order. If the startTime is not specified in the order, the startTime defaults to the Author dateTime (the time the order is signed).
  • stopTime - when the medication supply provided by the medication order is expected to be completed, including all fulfillments covered by the number of refills.

Note that when calculating cumulative medication duration, the stopTime may be present directly in the medication order. If the stopTime is not available, the duration in days is the difference between the Relevant Period start and stop times multiplied by (1 + the number of refills).

Direct Reference Code

Constrained to 'Birth date' LOINC code

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Birthdate

The Patient Characteristic Birthdate data element should document the patient’s date of birth. Timing: The Patient Characteristic, Birthdate is a single point in time representing the date and time of birth. It does not have a start and stop time. Note: Patient Characteristic Birthdate is fixed to LOINC code 21112-8 (Birth date) and therefore cannot be further qualified with a value set.

Value Set Description from VSAC
Clinical Focus: n/a Data Element Scope: n/a Inclusion Criteria: n/a Exclusion Criteria: n/a

Constrained to codes in the Patient Characteristic, Ethnicity: Ethnicity value set (2.16.840.1.114222.4.11.837)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Ethnicity

Data elements that meet criteria using this datatype should document that the patient has one or more of the ethnicities indicated by the QDM category and its corresponding value set.

Timing: Ethnicity does not have a specific timing. Measures using Patient Characteristic, Ethnicity should address the most recent entry in the clinical record.

Value Set Description from VSAC
Clinical Focus: Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system
Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC
Inclusion Criteria: All codes in the code system
Exclusion Criteria: none

Constrained to codes in the Patient Characteristic, Payer: Payer value set (2.16.840.1.114222.4.11.3591)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Payer

Data elements that meet criteria using this datatype should document that the patient has one or more of the payers indicated by the QDM category and its corresponding value set.

Timing: The Relevant Period addresses:

  • startTime – the first day of insurance coverage with the referenced payer
  • stopTime – the last day of insurance coverage with the referenced payer

 

Value Set Description from VSAC
Clinical Focus: n/a Data Element Scope: n/a Inclusion Criteria: n/a Exclusion Criteria: n/a

Constrained to codes in the Patient Characteristic, Race: Race value set (2.16.840.1.114222.4.11.836)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Race

Data elements that meet criteria using this datatype should document the patient’s race.

Timing: Race does not have a specific timing. Measures using Patient Characteristic, Race should address the most recent entry in the clinical record.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a patient's race as white.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Patient Characteristic Race.
Inclusion Criteria: Includes only relevant concepts associated with a code to identify a patient's race as white. This is a grouping of a CDCREC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Patient Characteristic, Race: White value set (2.16.840.1.113883.3.464.1003.123.12.1007)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Race

Data elements that meet criteria using this datatype should document the patient’s race.

Timing: Race does not have a specific timing. Measures using Patient Characteristic, Race should address the most recent entry in the clinical record.

Value Set Description from VSAC
Clinical Focus: Concepts that represent Female when assessing quality measures
Data Element Scope: Gender
Inclusion Criteria: Appropriate female gender concepts
Exclusion Criteria: Concepts representing Male gender

Constrained to codes in the Patient Characteristic, Sex: Female value set (2.16.840.1.113883.3.560.100.2)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Sex

Data elements that meet criteria using this datatype should document that the patient's sex matches the QDM category and its corresponding value set.

Timing: Birth (administrative) sex does not have a specific timing.

Value Set Description from VSAC
Clinical Focus: Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
Data Element Scope: Gender
Inclusion Criteria: Male and Female only.
Exclusion Criteria: Any gender identity that is not male or female.

Constrained to codes in the Patient Characteristic, Sex: ONC Administrative Sex value set (2.16.840.1.113762.1.4.1)

QDM Datatype and Definition (QDM Version 5.4)

Patient Characteristic Sex

Data elements that meet criteria using this datatype should document that the patient's sex matches the QDM category and its corresponding value set.

Timing: Birth (administrative) sex does not have a specific timing.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent a body mass index (BMI) ratio.
Data Element Scope: This value set may use the Quality Data Model (QDM) category or attribute related to Procedure.
Inclusion Criteria: Includes only relevant concepts associated with or related to BMI ratio.
Exclusion Criteria: No exclusions.

Constrained to codes in the Physical Exam, Performed: BMI Ratio value set (2.16.840.1.113883.3.600.1.1490)

QDM Datatype and Definition (QDM Version 5.4)

Physical Exam, Performed

Data elements that meet criteria using this datatype should document the completion of the physical exam indicated by the QDM category and its corresponding value set.

Timing: The Relevant Period addresses:

  • startTime – the time the physical examination activity begins
  • stopTime – the time the physical examination activity ends

NOTE - timing refers to a single instance of a physical examination activity. If a measure seeks to evaluate multiple physical examination activities over a period of time, the measure developer should use CQL logic to represent the query request.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent codes that can be used to identify patients who have undergone a partial or total removal of the stomach by either a laparoscopic or open method.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Procedure, Performed.
Inclusion Criteria: Includes only relevant concepts associated with identifying procedures for repair or removal of digestive system organs that includes a partial or total removal of the stomach. This is a grouping of CT and SNOMED CT codes.
Exclusion Criteria: Excludes endoscopic excision of tissue of stomach, excision/laparoscopic wedge resection of lesion of stomach and incisional biopsy of stomach.

Constrained to codes in the Procedure, Performed: Gastric Bypass Surgery value set (2.16.840.1.113883.3.464.1003.198.12.1050)

QDM Datatype and Definition (QDM Version 5.4)

Procedure, Performed

Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime -the time the procedure begins,
  • stopTime -the time the procedure is completed

NOTE:

  1. Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request.
  2. The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent the type and frequency of tobacco use.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype or attribute related to Diagnosis or Finding.
Inclusion Criteria: Includes only relevant concepts associated with type and frequency of tobacco user.
Exclusion Criteria: No exclusions.

Constrained to codes in the Result: Current Tobacco Smoker value set (2.16.840.1.113883.3.600.2390)

QDM Attribute and Definition (QDM Version 5.4)

Result

The final consequences or data collected from the datatype. Results can be used in four ways, to express: (1) That a result is present in the electronic record but any entry is acceptable. (2) A numerical result is reported directly as a value. Values may be integers or decimal numbers without units, or as a quantity with a value and units. Examples: 100 mg/dL for a lab test, 140 mmHg for blood pressure, as a percentage (actually a quantity with % as units), as a ratio (e.g., 1:4, 1:80). (3) A result that matches one of a specific set of coded concepts in a value set or a code that matches a direct reference code. (4) A result as a dateTime (Assessment, Performed and components). Note: Measures use Clinical Quality Language (CQL) logic to express the mathematical operators to constrain desired results to those above or below a certain threshold.