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Condition/Diagnosis/Problem

A QDM category consists of a single clinical concept identified by a value set.

Performance/Reporting Period
2022
QDM Category (QDM Version 5.5 Guidance Update):

Condition/Diagnosis/Problem represents a practitioner's identification of a patient's disease, illness, injury, or condition. This category contains a single datatype to represent all these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable but may also represent neutral or favorable conditions that affect a patient's plan of care (e.g., pregnancy).

The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient's problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED CT, but diagnoses may also be encoded using ICD-9-CM and/or ICD-10-CM.

The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

Data Elements defined by this QDM Datatype:
Last Updated: Jul 08, 2021