Back to top
Top
CMS Measure ID:
Version:
8
NQF Number:
None
Performance/Reporting Period
2019
Description:

Percentage of patients 18 years of age and older with congestive heart failure who completed initial and follow-up patient-reported functional status assessments

Data Elements contained within the eCQM + Expand all

Direct Reference Code

Constrained to 'Clinical summary score [KCCQ]' LOINC code

QDM Datatype and Definition (QDM Version 5.3)

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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) physical limitation score.
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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) physical limitation score. This is a grouping of a LOINC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: KCCQ Physical Limitation Score value set (2.16.840.1.113883.3.464.1003.118.12.1220)

QDM Datatype and Definition (QDM Version 5.3)

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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) self-efficacy score.
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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) self-efficacy score. This is a grouping of a LOINC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: KCCQ Self Efficacy Score value set (2.16.840.1.113883.3.464.1003.118.12.1221)

QDM Datatype and Definition (QDM Version 5.3)

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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) social limitation score.
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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) social limitation score. This is a grouping of a LOINC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: KCCQ Social Limitation Score value set (2.16.840.1.113883.3.464.1003.118.12.1222)

QDM Datatype and Definition (QDM Version 5.3)

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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) total symptom score.
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 the Kansas City Cardiomyopathy Questionnaire (KCCQ) total symptom score. This is a grouping of a LOINC code.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: KCCQ Total Symptom Score value set (2.16.840.1.113883.3.464.1003.118.12.1223)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 10 Global Mental Health Score.
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 the PROMIS 10 Global Mental Health Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 10 Global Mental Health Score value set (2.16.840.1.113883.3.464.1003.118.12.1138)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 10 Global Physical Health Score.
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 the PROMIS 10 Global Physical Health Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 10 Global Physical Health Score value set (2.16.840.1.113883.3.464.1003.118.12.1139)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Anxiety Score.
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 the PROMIS 29 Anxiety Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Anxiety Score value set (2.16.840.1.113883.3.464.1003.118.12.1216)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Depression Score.
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 the PROMIS 29 Depression Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Depression Score value set (2.16.840.1.113883.3.464.1003.118.12.1215)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Fatigue Score.
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 the PROMIS 29 Fatigue Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Fatigue Score value set (2.16.840.1.113883.3.464.1003.118.12.1214)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Pain Interference Score.
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 the PROMIS 29 Pain Interference Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Pain Interference Score value set (2.16.840.1.113883.3.464.1003.118.12.1213)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Physical Function Score.
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 the PROMIS 29 Physical Function Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Physical Function Score value set (2.16.840.1.113883.3.464.1003.118.12.1212)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Sleep Disturbance Score.
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 the PROMIS 29 Sleep Disturbance Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Sleep Disturbance Score value set (2.16.840.1.113883.3.464.1003.118.12.1211)

QDM Datatype and Definition (QDM Version 5.3)

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 the PROMIS 29 Satisfaction with Social Roles Score.
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 the PROMIS 29 Satisfaction with Social Roles Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: PROMIS 29 Social Roles Score value set (2.16.840.1.113883.3.464.1003.118.12.1217)

QDM Datatype and Definition (QDM Version 5.3)

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 'Quality of life score [KCCQ]' LOINC code

QDM Datatype and Definition (QDM Version 5.3)

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 the Veterans RAND 36 Item Health Survey (VR-36) Mental Component Summary (MCS) Score.
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 codes to identify the Veterans RAND 36 Item Health Survey (VR-36) Mental Component Summary (MCS) Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: VR 36 Mental Component Summary (MCS) Score value set (2.16.840.1.113883.3.464.1003.118.12.1225)

QDM Datatype and Definition (QDM Version 5.3)

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 the Veterans RAND 36 Item Health Survey (VR-36) Physical Component Summary (PCS) Score.
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 the Veterans RAND 36 Item Health Survey (VR-36) Physical Component Summary (PCS) Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: VR 36 Physical Component Summary (PCS) Score value set (2.16.840.1.113883.3.464.1003.118.12.1226)

QDM Datatype and Definition (QDM Version 5.3)

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 the Veterans RAND 12 Item Health Survey (VR-12) Mental Component Summary (MCS) T-Score.
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 the Veterans RAND 12 Item Health Survey (VR-12) Mental Component Summary (MCS) T-Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: VR12 Mental Component T Score value set (2.16.840.1.113883.3.464.1003.118.12.1177)

QDM Datatype and Definition (QDM Version 5.3)

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 the Veterans RAND 12 Item Health Survey (VR-12) Physical Component Summary (PCS) T-Score.
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 the Veterans RAND 12 Item Health Survey (VR-12) Physical Component Summary (PCS) T-Score. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: VR12 Physical Component T Score value set (2.16.840.1.113883.3.464.1003.118.12.1176)

QDM Datatype and Definition (QDM Version 5.3)

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 heart failure.
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 heart failure.
Exclusion Criteria: Excludes chronic and acute right-sided heart failure, right heart failure, right ventricular failure, cardiac insufficiency due to prosthesis and following cardiac surgery, or pulmonale.

Constrained to codes in the Diagnosis: Heart Failure value set (2.16.840.1.113883.3.526.3.376)

QDM Datatype and Definition (QDM Version 5.3)

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 severe dementia.
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 severe dementia.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Severe Dementia value set (2.16.840.1.113883.3.526.3.1025)

QDM Datatype and Definition (QDM Version 5.3)

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 the most common inpatient encounter types.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Encounter. The intent of this data element is to identify patients who have had an inpatient encounter.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT codes representing inpatient encounter.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Encounter Inpatient value set (2.16.840.1.113883.3.666.5.307)

QDM Datatype and Definition (QDM Version 5.3)

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.

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 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 5.3)

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.

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 receiving hospice care outside of a hospital or long term care facility.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Procedure, Order or Intervention, Order. The intent of this value set is to identify all patients receiving hospice care outside of a hospital or long term care facility.
Inclusion Criteria: Includes only relevant concepts associated with hospice care concepts.
Exclusion Criteria: Excludes concepts for palliative care or comfort measures.

Constrained to codes in the Intervention, Order: Hospice care ambulatory value set (2.16.840.1.113762.1.4.1108.15)

QDM Datatype and Definition (QDM Version 5.3)

Intervention, Order

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

Timing: The time the order is signed; Author dateTime

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent patients receiving hospice care outside of a hospital or long term care facility.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Procedure, Order or Intervention, Order. The intent of this value set is to identify all patients receiving hospice care outside of a hospital or long term care facility.
Inclusion Criteria: Includes only relevant concepts associated with hospice care concepts.
Exclusion Criteria: Excludes concepts for palliative care or comfort measures.

Constrained to codes in the Intervention, Performed: Hospice care ambulatory value set (2.16.840.1.113762.1.4.1108.15)

QDM Datatype and Definition (QDM Version 5.3)

Intervention, Performed

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

Timing: The Relevant Period addresses:

  • startTime – the time the intervention begins
  • stopTime – the time the intervention ends

NOTE - timing refers to a single instance of an intervention. If a measure seeks to evaluate multiple interventions 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 whether the patient is Hispanic or not; ethnicity category defined by the Centers for Disease Control and Prevention and National Center for Health Statistics.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Patient Characteristic Ethnicity.
Inclusion Criteria: Includes only relevant concepts associated with ethnicity defined as Hispanic or Latino, or Not Hispanic or Latino.
Exclusion Criteria: No exclusions.

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 5.3)

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: This value set contains concepts that represent categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Patient Characteristic Payer.
Inclusion Criteria: Includes only relevant concepts associated with payer codes in the code system.
Exclusion Criteria: No exclusions.

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 5.3)

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: This value set contains concepts that represent the general race category reported by the patient - subject may have more than one; defined by the Centers for Disease Control and Prevention and National Center for Health Statistics.
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 the following race categories: American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, Other Race, White.
Exclusion Criteria: No exclusions.

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 5.3)

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 gender identity restricted to only male and female used in administrative situations requiring a restriction to these two categories.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Patient Characteristic Sex.
Inclusion Criteria: Includes relevant concepts associated with gender concepts for male and female only.
Exclusion Criteria: Excludes 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 5.3)

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.