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CMS Measure ID:
Version:
7
NQF Number:
33
Performance/Reporting Period
2019
Description:

Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia 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 vaginal intercourse.
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 concepts that indicate whether a patient has had vaginal intercourse.
Exclusion Criteria: No exclusions.

Constrained to codes in the Assessment, Performed: Sexually Active value set (2.16.840.1.113883.3.464.1003.121.12.1040)

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 exposure to infections that are primarily transmitted through sexual contact.
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 potential exposure to infection with a predominantly sexual mode of transmission.
Exclusion Criteria: Excludes codes for specific sexually transmitted infections.

Constrained to codes in the Diagnosis: Carrier of Predominantly Sexually Transmitted Infection value set (2.16.840.1.113883.3.464.1003.112.11.1023)

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 chlamydia infections.
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 relevant concepts associated with chlamydia infections. This is a grouping of ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Chlamydia value set (2.16.840.1.113883.3.464.1003.112.12.1003)

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 complications related to pregnancy or childbirth.
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 complications of pregnancy or childbirth. This is a grouping of ICD-10-CM, ICD-9-CM, and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Complications of Pregnancy, Childbirth and the Puerperium value set (2.16.840.1.113883.3.464.1003.111.12.1012)

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 genital herpes infections.
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 female genital herpes infections. This is a grouping of ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes codes that indicate male genital herpes infections.

Constrained to codes in the Diagnosis: Genital Herpes value set (2.16.840.1.113883.3.464.1003.110.12.1049)

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 gonococcal infections and other venereal diseases.
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 female gonococcal infections and other venereal disease. This is a grouping of ICD-10-CM, ICD-9-CM and SNOMED CT codes.
Exclusion Criteria: Excludes codes that indicate male gonococcal infections or male venereal disease.

Constrained to codes in the Diagnosis: Gonococcal Infections and Venereal Diseases value set (2.16.840.1.113883.3.464.1003.112.12.1001)

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 human immunodeficiency virus (HIV) disease.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Diagnosis.
Inclusion Criteria: Includes only relevant concepts associated with HIV and acquired immunodeficiency syndrome. This is a grouping of ICD-10-CM, ICD-9-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: HIV value set (2.16.840.1.113883.3.464.1003.120.12.1003)

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 inflammatory disease of female reproductive organs.
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 inflammatory diseases of female reproductive organs. This is a grouping of ICD-10-CM, ICD-9-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Inflammatory Diseases of Female Reproductive Organs value set (2.16.840.1.113883.3.464.1003.112.12.1004)

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 female reproductive conditions that may be related to sexual activity.
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 variety of reproductive conditions that may indicate sexual activity. This is a grouping of ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: Excludes codes for other reproductive conditions that could indicate sexual activity but that are already described in other value sets.

Constrained to codes in the Diagnosis: Other Female Reproductive Conditions value set (2.16.840.1.113883.3.464.1003.111.12.1006)

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 syphilis diagnosis.
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 identifying patients with syphilis. This is a grouping of ICD-10-CM, ICD-9-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Syphilis value set (2.16.840.1.113883.3.464.1003.112.12.1002)

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 diagnostic studies that would be performed during pregnancy on a fetus (e.g., fetal ultrasound).
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Diagnostic Study, Order.
Inclusion Criteria: Includes only relevant concepts associated with diagnostic studies conducted on a fetus. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnostic Study, Order: Diagnostic Studies During Pregnancy value set (2.16.840.1.113883.3.464.1003.111.12.1008)

QDM Datatype and Definition (QDM Version 5.3)

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 any radiology study involving x-rays.
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 tests such as computerized tomography, x-ray, magnetic resonance imaging or radiofrequency testing. This is a grouping of LOINC codes.
Exclusion Criteria: Excludes codes that indicate that this test was ordered only, and not necessarily performed.

Constrained to codes in the Diagnostic Study, Order: X-Ray Study (all inclusive) value set (2.16.840.1.113883.3.464.1003.198.12.1034)

QDM Datatype and Definition (QDM Version 5.3)

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 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 a home health visit by a provider for the evaluation or management of a new or existing patient.
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 home visits for the evaluation and management of a new or established patient. This is a grouping value set of CPT and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Home Healthcare Services value set (2.16.840.1.113883.3.464.1003.101.12.1016)

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 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 over the age of 18. 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 5.3)

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 initial comprehensive preventive medical evaluation, including regular preventive care or care of small problem or preexisting condition that requires no extra work, to be associated with patients 0-17 years of age, that have no prior outpatient professional services from the physician practice in the last 3 years.
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 ages 0-17, and that indicate initial comprehensive preventive medical evaluation, including regular preventive care or care of small problem or preexisting condition that requires no extra work, for a patient that has no prior outpatient professional services from the physician practice in the last 3 years. This is a grouping value set of CPT codes.
Exclusion Criteria: Excludes codes that are not for comprehensive preventive medical evaluations and codes that are for patients who have been seen in the last 3 years.

Constrained to codes in the Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17 value set (2.16.840.1.113883.3.464.1003.101.12.1022)

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 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 over the age of 18. 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 1 value set (2.16.840.1.113883.3.464.1003.101.12.1023)

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 initial comprehensive preventive medical evaluation, including regular preventive care or care of small problem or preexisting condition that requires no extra work, to be associated with patients 0-17 years of age, that received prior outpatient professional services from the physician practice in the last 3 years.
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 ages 0-17, and indicating initial comprehensive preventive medical evaluation, including regular preventive care or care of small problem or preexisting condition that requires no extra work, for a patient that received prior outpatient professional services from the physician practice in the last 3 years. This is a grouping value set of CPT codes.
Exclusion Criteria: Excludes codes that are not for comprehensive preventive medical evaluations and codes that are for patients who have not been seen in the last 3 years.

Constrained to codes in the Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17 value set (2.16.840.1.113883.3.464.1003.101.12.1024)

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 lab tests conducted during pregnancy (e.g., tests conducted on amniotic fluid).
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Laboratory Test.
Inclusion Criteria: Includes only relevant concepts associated with laboratory tests conducted during pregnancy. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Laboratory Test, Order: Lab Tests During Pregnancy value set (2.16.840.1.113883.3.464.1003.111.12.1007)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Order

Data elements that meet criteria using this datatype should document a request for the laboratory test 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 laboratory tests for sexually transmitted infections.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Laboratory Test, Order.
Inclusion Criteria: Includes only relevant concepts associated with laboratory tests for sexually transmitted infections in females. This is a grouping of LOINC codes.
Exclusion Criteria: Excludes codes that indicate lab tests for sexually transmitted infections in male patients.

Constrained to codes in the Laboratory Test, Order: Lab Tests for Sexually Transmitted Infections value set (2.16.840.1.113883.3.464.1003.110.12.1051)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Order

Data elements that meet criteria using this datatype should document a request for the laboratory test 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 identify cervical cytology tests.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Laboratory Test, Order or Laboratory Test, Performed.
Inclusion Criteria: Includes only relevant concepts associated with cervical cytology tests. This is a grouping of LOINC codes.
Exclusion Criteria: Excludes cytology performed on non-cervical samples. Excludes codes that indicate that this test was ordered only, and not necessarily performed.

Constrained to codes in the Laboratory Test, Order: Pap Test value set (2.16.840.1.113883.3.464.1003.108.12.1017)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Order

Data elements that meet criteria using this datatype should document a request for the laboratory test 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 urine, serum, or plasma pregnancy tests.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Laboratory Test, Order.
Inclusion Criteria: Includes only relevant concepts associated with conducting a pregnancy test. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Laboratory Test, Order: Pregnancy Test value set (2.16.840.1.113883.3.464.1003.111.12.1011)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Order

Data elements that meet criteria using this datatype should document a request for the laboratory test 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 laboratory testing for chlamydia infections.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Laboratory Test, Performed.
Inclusion Criteria: Includes only relevant concepts associated with tests for chlamydia infection. This is a grouping of LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Laboratory Test, Performed: Chlamydia Screening value set (2.16.840.1.113883.3.464.1003.110.12.1052)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Performed

Data elements that meet criteria using this datatype should document the laboratory test indicated by the QDM category and its corresponding value set was performed.

Timing: The Relevant Period addresses:

  • startTime – when the laboratory test is initiated (i.e., the time the specimen collection begins)
  • stopTime – when the laboratory test is completed (i.e., the time the specimen collection ends)

Examples:

  • Initiation of a venipuncture for a fasting blood glucose to the time venipuncture for the fasting blood glucose is completed – basically a single point in time for many specimen collections
  • Initiation of a 24-hour urine collection for measured creatinine clearance until completion of the 24-hour urine collection

Note – the time that the result report is available is a separate attribute than the time of the study (specimen collection).

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent identify cervical cytology tests.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Laboratory Test, Order or Laboratory Test, Performed.
Inclusion Criteria: Includes only relevant concepts associated with cervical cytology tests. This is a grouping of LOINC codes.
Exclusion Criteria: Excludes cytology performed on non-cervical samples. Excludes codes that indicate that this test was ordered only, and not necessarily performed.

Constrained to codes in the Laboratory Test, Performed: Pap Test value set (2.16.840.1.113883.3.464.1003.108.12.1017)

QDM Datatype and Definition (QDM Version 5.3)

Laboratory Test, Performed

Data elements that meet criteria using this datatype should document the laboratory test indicated by the QDM category and its corresponding value set was performed.

Timing: The Relevant Period addresses:

  • startTime – when the laboratory test is initiated (i.e., the time the specimen collection begins)
  • stopTime – when the laboratory test is completed (i.e., the time the specimen collection ends)

Examples:

  • Initiation of a venipuncture for a fasting blood glucose to the time venipuncture for the fasting blood glucose is completed – basically a single point in time for many specimen collections
  • Initiation of a 24-hour urine collection for measured creatinine clearance until completion of the 24-hour urine collection

Note – the time that the result report is available is a separate attribute than the time of the study (specimen collection).

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent contraceptive medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Active or Medication, Order.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable. Includes only relevant concepts associated with contraceptive medications. This is a grouping of RxNorm codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Medication, Active: Contraceptive Medications value set (2.16.840.1.113883.3.464.1003.196.12.1080)

QDM Datatype and Definition (QDM Version 5.3)

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.

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 contraceptive medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Active or Medication, Order.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable. Includes only relevant concepts associated with contraceptive medications. This is a grouping of RxNorm codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Medication, Order: Contraceptive Medications value set (2.16.840.1.113883.3.464.1003.196.12.1080)

QDM Datatype and Definition (QDM Version 5.3)

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).

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent isotretinoin medications.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Medication, Ordered.
Inclusion Criteria: Includes only relevant concepts associated with semantic clinical drugs (concepts associated with component, form and strength); generic; prescribable; isotretinoin only. This is a grouping of RxNorm codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Medication, Order: Isotretinoin value set (2.16.840.1.113883.3.464.1003.196.12.1143)

QDM Datatype and Definition (QDM Version 5.3)

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).

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 female.
Data Element Scope: This value set may use the Quality Data Model (QDM) datatype related to Patient Characteristic Sex.
Inclusion Criteria: Includes only relevant concepts associated with appropriate female gender concepts.
Exclusion Criteria: Excludes 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 5.3)

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.

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.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent single or multiple live births.
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 delivery of one or multiple newborns. This is a grouping of CPT, SNOMED CT and ICD-10-PCS codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Procedure, Performed: Delivery Live Births value set (2.16.840.1.113883.3.464.1003.111.12.1015)

QDM Datatype and Definition (QDM Version 5.3)

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 procedures conducted during pregnancy.
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 procedures conducted on a patient during pregnancy. This is a grouping of CPT and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Procedure, Performed: Procedures During Pregnancy value set (2.16.840.1.113883.3.464.1003.111.12.1009)

QDM Datatype and Definition (QDM Version 5.3)

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 procedures involving contraceptive devices.
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 procedures related to contraceptive devices. This is a grouping of CPT, HCPCS and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Procedure, Performed: Procedures Involving Contraceptive Devices value set (2.16.840.1.113883.3.464.1003.111.12.1010)

QDM Datatype and Definition (QDM Version 5.3)

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.