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FHIR IG Statistics: Measure/CMS124FHIRCervicalCancerScreening

Packagegov.healthit.ecqi.ecqms
Resource TypeMeasure
IdCMS124FHIRCervicalCancerScreening
FHIR VersionR4
Sourcehttp://ecqi.healthit.gov/ecqms/https://build.fhir.org/ig/cqframework/ecqm-content-qicore-2025/Measure-CMS124FHIRCervicalCancerScreening.html
URLhttps://madie.cms.gov/Measure/CMS124FHIRCervicalCancerScreening
Version0.4.000
Statusactive
Date2025-06-27T21:16:57+00:00
NameCMS124FHIRCervicalCancerScreening
TitleCervical Cancer ScreeningFHIR
DescriptionPercentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed within the last 3 years - Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years
CopyrightThis Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.

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Narrative

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Metadata
Title Cervical Cancer ScreeningFHIR
Version 0.4.000
Short Name CMS124FHIR
GUID (Version Independent) urn:uuid:3be5df74-24e1-46ed-b899-6e98b9e3760b
GUID (Version Specific) urn:uuid:d5fb530b-1d57-424b-a8e2-3ef76f0f30c2
CMS Identifier 124FHIR
Effective Period 2026-01-01 through 2026-12-31
Steward (Publisher) National Committee for Quality Assurance
Developer National Committee for Quality Assurance
Description

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed within the last 3 years - Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years
Copyright

This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.
Disclaimer

The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Rationale

All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).
Clinical Recommendation Statement

The U.S Preventive Services Task Force (USPSTF) recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) (A recommendation) (USPSTF, 2018). The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer (D recommendation) (USPSTF, 2018). The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) (USPSTF, 2018). The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion (i.e., cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer (D recommendation) (USPSTF, 2018).
Citation

CITATION - American Cancer Society. (2020). Cancer Facts & Figures 2020. Atlanta: American Cancer Society.
Citation

CITATION - National Cancer Institute. (2020). Cancer of the Cervix Uteri - Cancer Stat Facts. https://seer.cancer.gov/statfacts/html/cervix.html
Citation

CITATION - US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., … Wong, J. B. (2018). Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 320(7), 674–686. https://doi.org/10.1001/jama.2018.10897
Guidance (Usage) To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. Evidence of hrHPV testing within the last 5 years also captures patients who had cotesting; therefore additional methods to identify cotesting are not necessary. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS124v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
Measure Group (Rate) (ID: Group_1)
Basis boolean
Scoring Proportion
Type Process
Rate Aggregation None
Improvement Notation Increased score indicates improvement
Initial Population ID: InitialPopulation_1
Description:

Women 24-64 years of age by the end of the measurement period with a visit during the measurement period

Logic Definition: Initial Population
Denominator ID: Denominator_1
Description:

Equals Initial Population

Logic Definition: Denominator
Denominator Exclusion ID: DenominatorExclusion_1
Description:

Exclude patients who are in hospice care for any part of the measurement period. Women who had a hysterectomy with no residual cervix or a congenital absence of cervix. Exclude patients receiving palliative care for any part of the measurement period.

Logic Definition: Denominator Exclusions
Numerator ID: Numerator_1
Description:

Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria: - Cervical cytology performed during the measurement period or the two years prior to the measurement period for women 24-64 years of age by the end of the measurement period. - Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.

Logic Definition: Numerator
Supplemental Data Guidance For every patient evaluated by this measure also identify payer, race, ethnicity and sex
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: SDE Ethnicity
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: SDE Payer
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: SDE Race
Logic Definition: SDE Race
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: SDE Sex
Logic Definition: SDE Sex
Measure Logic
Primary Library CMS124FHIRCervicalCancerScreening
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population 
define "Initial Population":   AgeInYearsAt(date from      end of "Measurement Period"   ) in Interval[24, 64]     and Patient.sex = '248152002'     and exists "Qualifying Encounters"
Denominator 
define "Denominator":   "Initial Population"
Denominator Exclusion 
define "Denominator Exclusions":   Hospice."Has Hospice Services"     or exists "Absence of Cervix"     or PalliativeCare."Has Palliative Care in the Measurement Period"
Numerator 
define "Numerator":   exists "Cervical Cytology Within 3 Years"     or exists "HPV Test Within 5 Years for Women Age 30 and Older"
Logic Definitions
Logic Definition Library Name: Hospice 
define "Has Hospice Services":   exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter       where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"           or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"       )         and InpatientEncounter.period ends during day of "Measurement Period"   )     or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter         where HospiceEncounter.period overlaps day of "Measurement Period"     )     or exists ((([ObservationScreeningAssessment: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment         where HospiceAssessment.value ~ "Yes (qualifier value)"           and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"     )     or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder         where HospiceOrder.authoredOn during day of "Measurement Period"     )     or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed         where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"     )     or exists ((([ConditionProblemsHealthConcerns: "Hospice Diagnosis"]         union [ConditionEncounterDiagnosis: "Hospice Diagnosis"]).verified()) HospiceCareDiagnosis         where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"     )
Logic Definition Library Name: PalliativeCare 
define "Has Palliative Care in the Measurement Period":   exists ((([ObservationScreeningAssessment: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment       where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"   )     or exists ((([ConditionProblemsHealthConcerns: "Palliative Care Diagnosis"]     union [ConditionEncounterDiagnosis: "Palliative Care Diagnosis"]).verified()) PalliativeDiagnosis         where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"     )     or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter         where PalliativeEncounter.period overlaps day of "Measurement Period"     )     or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention         where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"     )
Logic Definition Library Name: SupplementalDataElements 
define "SDE Sex":   case     when Patient.sex = '248153007' then "Male (finding)"     when Patient.sex = '248152002' then "Female (finding)"     else null   end
Logic Definition Library Name: SupplementalDataElements 
define "SDE Payer":   [Coverage: type in "Payer Type"] Payer     return {       code: Payer.type,       period: Payer.period     }
Logic Definition Library Name: SupplementalDataElements 
define "SDE Ethnicity":   Patient.ethnicity E     return Tuple {       codes: { E.ombCategory } union E.detailed,       display: E.text     }
Logic Definition Library Name: SupplementalDataElements 
define "SDE Race":   Patient.race R     return Tuple {       codes: R.ombCategory union R.detailed,       display: R.text     }
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "SDE Sex":   SDE."SDE Sex"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Cervical Cytology Within 3 Years":   ( ( [LaboratoryResultObservation: "Pap Test"] ).isLaboratoryTestPerformed ( ) ) CervicalCytology     where CervicalCytology.effective.latest ( ) during day of Interval[start of "Measurement Period" - 2 years, end of "Measurement Period"]       and CervicalCytology.value is not null
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "HPV Test Within 5 Years for Women Age 30 and Older":   ( ( [LaboratoryResultObservation: "HPV Test"] ).isLaboratoryTestPerformed ( ) ) HPVTest     where AgeInYearsAt(date from HPVTest.effective.latest()) >= 30       and HPVTest.effective.latest ( ) during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]       and HPVTest.value is not null
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Numerator":   exists "Cervical Cytology Within 3 Years"     or exists "HPV Test Within 5 Years for Women Age 30 and Older"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Qualifying Encounters":   ( ( [Encounter: "Office Visit"]       union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]       union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]       union [Encounter: "Home Healthcare Services"]       union [Encounter: "Telephone Visits"]       union [Encounter: "Virtual Encounter"]   ).isEncounterPerformed ( ) ) ValidEncounters     where ValidEncounters.period during day of "Measurement Period"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Initial Population":   AgeInYearsAt(date from      end of "Measurement Period"   ) in Interval[24, 64]     and Patient.sex = '248152002'     and exists "Qualifying Encounters"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Denominator":   "Initial Population"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "SDE Payer":   SDE."SDE Payer"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "SDE Ethnicity":   SDE."SDE Ethnicity"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Absence of Cervix":   ( ( ( [Procedure: "Hysterectomy with No Residual Cervix"] ).isProcedurePerformed ( ) ) NoCervixProcedure       where NoCervixProcedure.performed.toInterval ( ) ends on or before end of "Measurement Period"   )     union ( ( ( [ConditionProblemsHealthConcerns: "Congenital or Acquired Absence of Cervix"]           union [ConditionEncounterDiagnosis: "Congenital or Acquired Absence of Cervix"]       ).verified ( ) ) NoCervixDiagnosis         where NoCervixDiagnosis.prevalenceInterval ( ) starts on or before end of "Measurement Period"     )
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "Denominator Exclusions":   Hospice."Has Hospice Services"     or exists "Absence of Cervix"     or PalliativeCare."Has Palliative Care in the Measurement Period"
Logic Definition Library Name: CMS124FHIRCervicalCancerScreening 
define "SDE Race":   SDE."SDE Race"
Logic Definition Library Name: FHIRHelpers 
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers 
/* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period):     if period is null then         null     else         if period."start" is null then             Interval(period."start".value, period."end".value]         else             Interval[period."start".value, period."end".value]
Logic Definition Library Name: FHIRHelpers 
/* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding):     if coding is null then         null     else         System.Code {           code: coding.code.value,           system: coding.system.value,           version: coding.version.value,           display: coding.display.value         }
Logic Definition Library Name: QICoreCommon 
/* @description: Given an interval, returns the ending point if the interval has an ending boundary specified, otherwise, returns the starting point */ define fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):   (choice.toInterval()) period     return       if (period."hasEnd"()) then end of period       else start of period
Logic Definition Library Name: QICoreCommon 
/* @description: Given an interval, returns true if the interval has an ending boundary specified (i.e. the end of the interval is not null and not the maximum DateTime value) */ define fluent function hasEnd(period Interval<DateTime> ):   not (     end of period is null       or end of period = maximum DateTime   )
Logic Definition Library Name: QICoreCommon 
/* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in QICore, allowing this function to be used across any resource. The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime. If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age, and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later. If the input is a DateTime Interval, the result is the input. If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending immediately before one year later than the date the patient turned the age given as the end of the quantity interval. If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval */ define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):   case    when choice is DateTime then      Interval[choice as DateTime, choice as DateTime]   when choice is Interval<DateTime> then     choice as Interval<DateTime>   when choice is Quantity then     Interval[Patient.birthDate + (choice as Quantity),      Patient.birthDate + (choice as Quantity) + 1 year)   when choice is Interval<Quantity> then     Interval[Patient.birthDate + (choice.low as Quantity),      Patient.birthDate + (choice.high as Quantity) + 1 year)   when choice is Timing then       Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>   else    null as Interval<DateTime>  end
Logic Definition Library Name: Status 
//Laboratory Test, Performed define fluent function isLaboratoryTestPerformed(Obs List<LaboratoryResultObservation>):   Obs O     where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: Status 
//Encounter, Performed //General usage unless required otherwise by measure intent (e.g., follow-up encounters) define fluent function isEncounterPerformed(Enc List<Encounter>):   Enc E     where E.status = 'finished'
Logic Definition Library Name: Status 
//Assessment, Performed define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):   Obs O     where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: Status 
//Intervention, Order define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):   ServiceRequest S     where S.status in { 'active', 'completed' }       and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition Library Name: Status 
//Intervention, Performed define fluent function isInterventionPerformed(Proc List<Procedure>):   Proc P     where P.status ~ 'completed'
Logic Definition Library Name: Status 
//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.  //Condition //Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):   conditions C     where C.verificationStatus is not null implies       (C.verificationStatus ~ "confirmed"         or C.verificationStatus ~ "unconfirmed"         or C.verificationStatus ~ "provisional"         or C.verificationStatus ~ "differential"       )
Logic Definition Library Name: Status 
//Procedure, Performed define fluent function isProcedurePerformed(Proc List<Procedure>):   Proc P     where P.status ~ 'completed'
Terminology
Code System Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Code System Description: Code system LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Code System Description: Code system ConditionVerificationStatusCodes
Resource: ConditionVerificationStatus
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status
Value Set Description: Value set Pap Test
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017
Value Set Description: Value set HPV Test
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059
Value Set Description: Value set Office Visit
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Value Set Description: Value set Preventive Care Services Established Office Visit, 18 and Up
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Value Set Description: Value set Preventive Care Services Initial Office Visit, 18 and Up
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Value Set Description: Value set Home Healthcare Services
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Value Set Description: Value set Telephone Visits
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Value Set Description: Value set Virtual Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Value Set Description: Value set Payer Type
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Value Set Description: Value set Encounter Inpatient
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Value Set Description: Value set Hospice Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Value Set Description: Value set Hospice Care Ambulatory
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Value Set Description: Value set Hospice Diagnosis
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Value Set Description: Value set Hysterectomy with No Residual Cervix
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014
Value Set Description: Value set Congenital or Acquired Absence of Cervix
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1016
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1016
Value Set Description: Value set Palliative Care Diagnosis
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Value Set Description: Value set Palliative Care Encounter
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Value Set Description: Value set Palliative Care Intervention
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Direct Reference Code Display: Male (finding)
Code: 248153007
System: http://snomed.info/sct
Direct Reference Code Display: Female (finding)
Code: 248152002
System: http://snomed.info/sct
Direct Reference Code Display: Discharge to home for hospice care (procedure)
Code: 428361000124107
System: http://snomed.info/sct
Direct Reference Code Display: Discharge to healthcare facility for hospice care (procedure)
Code: 428371000124100
System: http://snomed.info/sct
Direct Reference Code Display: Hospice care [Minimum Data Set]
Code: 45755-6
System: http://loinc.org
Direct Reference Code Display: Yes (qualifier value)
Code: 373066001
System: http://snomed.info/sct
Direct Reference Code Display: confirmed
Code: confirmed
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: unconfirmed
Code: unconfirmed
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: provisional
Code: provisional
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: differential
Code: differential
System: http://terminology.hl7.org/CodeSystem/condition-ver-status
Direct Reference Code Display: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
Code: 71007-9
System: http://loinc.org
Dependencies
Dependency Description: Library SDE
Resource: SupplementalDataElementsversion: null5.1.000)
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
Dependency Description: Library FHIRHelpers
Resource: FHIRHelpersversion: null4.4.000)
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library Status
Resource: Statusversion: null1.15.000)
Canonical URL: https://madie.cms.gov/Library/Status|1.15.000
Dependency Description: Library QICoreCommon
Resource: QICoreCommonversion: null4.0.000)
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Dependency Description: Library Hospice
Resource: Hospiceversion: null6.18.000)
Canonical URL: https://madie.cms.gov/Library/Hospice|6.18.000
Dependency Description: Library PalliativeCare
Resource: PalliativeCareversion: null1.18.000)
Canonical URL: https://madie.cms.gov/Library/PalliativeCare|1.18.000
Data Requirements
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: extension, url, birthDate, birthDate.value
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, effective, value, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
Must Support Elements: code, effective, value, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, status, status.value, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, status, status.value
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Data Requirement Type: Coverage
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, value, effective, status, status.value
Code Filter(s):
Path: code
Code(s): LOINC 45755-6: Hospice care [Minimum Data Set]
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
Must Support Elements: code, effective, status, status.value
Code Filter(s):
Path: code
Code(s): LOINC 71007-9: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1016
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1016
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Generated using version 0.4.8 of the sample-content-ig Liquid templates

Source

{
  "resourceType": "Measure",
  "id": "CMS124FHIRCervicalCancerScreening",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "248153007",
            "display": "Male (finding)"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "248152002",
            "display": "Female (finding)"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "428361000124107",
            "display": "Discharge to home for hospice care (procedure)"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "428371000124100",
            "display": "Discharge to healthcare facility for hospice care (procedure)"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "45755-6",
            "display": "Hospice care [Minimum Data Set]"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "373066001",
            "display": "Yes (qualifier value)"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code": "confirmed",
            "display": "confirmed"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code": "unconfirmed",
            "display": "unconfirmed"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code": "provisional",
            "display": "provisional"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code": "differential",
            "display": "differential"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "71007-9",
            "display": "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"
          }
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "SupplementalDataElements"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Sex\":   case     when Patient.sex = '248153007' then \"Male (finding)\"     when Patient.sex = '248152002' then \"Female (finding)\"     else null   end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Sex\":   SDE.\"SDE Sex\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Cervical Cytology Within 3 Years"
            },
            {
              "url": "statement",
              "valueString": "define \"Cervical Cytology Within 3 Years\":   ( ( [LaboratoryResultObservation: \"Pap Test\"] ).isLaboratoryTestPerformed ( ) ) CervicalCytology     where CervicalCytology.effective.latest ( ) during day of Interval[start of \"Measurement Period\" - 2 years, end of \"Measurement Period\"]       and CervicalCytology.value is not null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "HPV Test Within 5 Years for Women Age 30 and Older"
            },
            {
              "url": "statement",
              "valueString": "define \"HPV Test Within 5 Years for Women Age 30 and Older\":   ( ( [LaboratoryResultObservation: \"HPV Test\"] ).isLaboratoryTestPerformed ( ) ) HPVTest     where AgeInYearsAt(date from HPVTest.effective.latest()) >= 30       and HPVTest.effective.latest ( ) during day of Interval[start of \"Measurement Period\" - 4 years, end of \"Measurement Period\"]       and HPVTest.value is not null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Numerator"
            },
            {
              "url": "statement",
              "valueString": "define \"Numerator\":   exists \"Cervical Cytology Within 3 Years\"     or exists \"HPV Test Within 5 Years for Women Age 30 and Older\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Qualifying Encounters"
            },
            {
              "url": "statement",
              "valueString": "define \"Qualifying Encounters\":   ( ( [Encounter: \"Office Visit\"]       union [Encounter: \"Preventive Care Services Established Office Visit, 18 and Up\"]       union [Encounter: \"Preventive Care Services Initial Office Visit, 18 and Up\"]       union [Encounter: \"Home Healthcare Services\"]       union [Encounter: \"Telephone Visits\"]       union [Encounter: \"Virtual Encounter\"]   ).isEncounterPerformed ( ) ) ValidEncounters     where ValidEncounters.period during day of \"Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\":   AgeInYearsAt(date from      end of \"Measurement Period\"   ) in Interval[24, 64]     and Patient.sex = '248152002'     and exists \"Qualifying Encounters\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Denominator"
            },
            {
              "url": "statement",
              "valueString": "define \"Denominator\":   \"Initial Population\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "SupplementalDataElements"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":   [Coverage: type in \"Payer Type\"] Payer     return {       code: Payer.type,       period: Payer.period     }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":   SDE.\"SDE Payer\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "SupplementalDataElements"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Ethnicity\":   Patient.ethnicity E     return Tuple {       codes: { E.ombCategory } union E.detailed,       display: E.text     }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 10
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Ethnicity\":   SDE.\"SDE Ethnicity\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 11
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Hospice"
            },
            {
              "url": "name",
              "valueString": "Has Hospice Services"
            },
            {
              "url": "statement",
              "valueString": "define \"Has Hospice Services\":   exists ((([Encounter: \"Encounter Inpatient\"]).isEncounterPerformed()) InpatientEncounter       where (InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"           or InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"       )         and InpatientEncounter.period ends during day of \"Measurement Period\"   )     or exists ((([Encounter: \"Hospice Encounter\"]).isEncounterPerformed()) HospiceEncounter         where HospiceEncounter.period overlaps day of \"Measurement Period\"     )     or exists ((([ObservationScreeningAssessment: \"Hospice care [Minimum Data Set]\"]).isAssessmentPerformed()) HospiceAssessment         where HospiceAssessment.value ~ \"Yes (qualifier value)\"           and HospiceAssessment.effective.toInterval() overlaps day of \"Measurement Period\"     )     or exists ((([ServiceRequest: \"Hospice Care Ambulatory\"]).isInterventionOrder()) HospiceOrder         where HospiceOrder.authoredOn during day of \"Measurement Period\"     )     or exists ((([Procedure: \"Hospice Care Ambulatory\"]).isInterventionPerformed()) HospicePerformed         where HospicePerformed.performed.toInterval() overlaps day of \"Measurement Period\"     )     or exists ((([ConditionProblemsHealthConcerns: \"Hospice Diagnosis\"]         union [ConditionEncounterDiagnosis: \"Hospice Diagnosis\"]).verified()) HospiceCareDiagnosis         where HospiceCareDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"     )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 12
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Absence of Cervix"
            },
            {
              "url": "statement",
              "valueString": "define \"Absence of Cervix\":   ( ( ( [Procedure: \"Hysterectomy with No Residual Cervix\"] ).isProcedurePerformed ( ) ) NoCervixProcedure       where NoCervixProcedure.performed.toInterval ( ) ends on or before end of \"Measurement Period\"   )     union ( ( ( [ConditionProblemsHealthConcerns: \"Congenital or Acquired Absence of Cervix\"]           union [ConditionEncounterDiagnosis: \"Congenital or Acquired Absence of Cervix\"]       ).verified ( ) ) NoCervixDiagnosis         where NoCervixDiagnosis.prevalenceInterval ( ) starts on or before end of \"Measurement Period\"     )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 13
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "PalliativeCare"
            },
            {
              "url": "name",
              "valueString": "Has Palliative Care in the Measurement Period"
            },
            {
              "url": "statement",
              "valueString": "define \"Has Palliative Care in the Measurement Period\":   exists ((([ObservationScreeningAssessment: \"Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)\"]).isAssessmentPerformed()) PalliativeAssessment       where PalliativeAssessment.effective.toInterval() overlaps day of \"Measurement Period\"   )     or exists ((([ConditionProblemsHealthConcerns: \"Palliative Care Diagnosis\"]     union [ConditionEncounterDiagnosis: \"Palliative Care Diagnosis\"]).verified()) PalliativeDiagnosis         where PalliativeDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"     )     or exists ((([Encounter: \"Palliative Care Encounter\"]).isEncounterPerformed()) PalliativeEncounter         where PalliativeEncounter.period overlaps day of \"Measurement Period\"     )     or exists ((([Procedure: \"Palliative Care Intervention\"]).isInterventionPerformed()) PalliativeIntervention         where PalliativeIntervention.performed.toInterval() overlaps day of \"Measurement Period\"     )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 14
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "Denominator Exclusions"
            },
            {
              "url": "statement",
              "valueString": "define \"Denominator Exclusions\":   Hospice.\"Has Hospice Services\"     or exists \"Absence of Cervix\"     or PalliativeCare.\"Has Palliative Care in the Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 15
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "SupplementalDataElements"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Race\":   Patient.race R     return Tuple {       codes: R.ombCategory union R.detailed,       display: R.text     }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 16
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "CMS124FHIRCervicalCancerScreening"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Race\":   SDE.\"SDE Race\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 17
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value uri): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 18
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isLaboratoryTestPerformed"
            },
            {
              "url": "statement",
              "valueString": "//Laboratory Test, Performed define fluent function isLaboratoryTestPerformed(Obs List<LaboratoryResultObservation>):   Obs O     where O.status in { 'final', 'amended', 'corrected' }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 19
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "QICoreCommon"
            },
            {
              "url": "name",
              "valueString": "latest"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Given an interval, returns the ending point if the interval has an ending boundary specified, otherwise, returns the starting point */ define fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):   (choice.toInterval()) period     return       if (period.\"hasEnd\"()) then end of period       else start of period"
            },
            {
              "url": "displaySequence",
              "valueInteger": 20
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "QICoreCommon"
            },
            {
              "url": "name",
              "valueString": "hasEnd"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Given an interval, returns true if the interval has an ending boundary specified (i.e. the end of the interval is not null and not the maximum DateTime value) */ define fluent function hasEnd(period Interval<DateTime> ):   not (     end of period is null       or end of period = maximum DateTime   )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 21
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isEncounterPerformed"
            },
            {
              "url": "statement",
              "valueString": "//Encounter, Performed //General usage unless required otherwise by measure intent (e.g., follow-up encounters) define fluent function isEncounterPerformed(Enc List<Encounter>):   Enc E     where E.status = 'finished'"
            },
            {
              "url": "displaySequence",
              "valueInteger": 22
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToInterval"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period):     if period is null then         null     else         if period.\"start\" is null then             Interval(period.\"start\".value, period.\"end\".value]         else             Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 23
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToCode"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding):     if coding is null then         null     else         System.Code {           code: coding.code.value,           system: coding.system.value,           version: coding.version.value,           display: coding.display.value         }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 24
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isAssessmentPerformed"
            },
            {
              "url": "statement",
              "valueString": "//Assessment, Performed define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):   Obs O     where O.status in { 'final', 'amended', 'corrected' }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 25
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isInterventionOrder"
            },
            {
              "url": "statement",
              "valueString": "//Intervention, Order define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):   ServiceRequest S     where S.status in { 'active', 'completed' }       and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"
            },
            {
              "url": "displaySequence",
              "valueInteger": 26
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isInterventionPerformed"
            },
            {
              "url": "statement",
              "valueString": "//Intervention, Performed define fluent function isInterventionPerformed(Proc List<Procedure>):   Proc P     where P.status ~ 'completed'"
            },
            {
              "url": "displaySequence",
              "valueInteger": 27
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "QICoreCommon"
            },
            {
              "url": "name",
              "valueString": "toInterval"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in QICore, allowing this function to be used across any resource. The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime. If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age, and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later. If the input is a DateTime Interval, the result is the input. If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending immediately before one year later than the date the patient turned the age given as the end of the quantity interval. If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval */ define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):   case    when choice is DateTime then      Interval[choice as DateTime, choice as DateTime]   when choice is Interval<DateTime> then     choice as Interval<DateTime>   when choice is Quantity then     Interval[Patient.birthDate + (choice as Quantity),      Patient.birthDate + (choice as Quantity) + 1 year)   when choice is Interval<Quantity> then     Interval[Patient.birthDate + (choice.low as Quantity),      Patient.birthDate + (choice.high as Quantity) + 1 year)   when choice is Timing then       Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>   else    null as Interval<DateTime>  end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 28
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "verified"
            },
            {
              "url": "statement",
              "valueString": "//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.  //Condition //Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):   conditions C     where C.verificationStatus is not null implies       (C.verificationStatus ~ \"confirmed\"         or C.verificationStatus ~ \"unconfirmed\"         or C.verificationStatus ~ \"provisional\"         or C.verificationStatus ~ \"differential\"       )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 29
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "Status"
            },
            {
              "url": "name",
              "valueString": "isProcedurePerformed"
            },
            {
              "url": "statement",
              "valueString": "//Procedure, Performed define fluent function isProcedurePerformed(Proc List<Procedure>):   Proc P     where P.status ~ 'completed'"
            },
            {
              "url": "displaySequence",
              "valueInteger": 30
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library SDE",
          "resource": "https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "https://madie.cms.gov/Library/FHIRHelpers|4.4.000"
        },
        {
          "type": "depends-on",
          "display": "Library Status",
          "resource": "https://madie.cms.gov/Library/Status|1.15.000"
        },
        {
          "type": "depends-on",
          "display": "Library QICoreCommon",
          "resource": "https://madie.cms.gov/Library/QICoreCommon|4.0.000"
        },
        {
          "type": "depends-on",
          "display": "Library Hospice",
          "resource": "https://madie.cms.gov/Library/Hospice|6.18.000"
        },
        {
          "type": "depends-on",
          "display": "Library PalliativeCare",
          "resource": "https://madie.cms.gov/Library/PalliativeCare|1.18.000"
        },
        {
          "type": "depends-on",
          "display": "Code system SNOMEDCT",
          "resource": "http://snomed.info/sct"
        },
        {
          "type": "depends-on",
          "display": "Code system LOINC",
          "resource": "http://loinc.org"
        },
        {
          "type": "depends-on",
          "display": "Code system ConditionVerificationStatusCodes",
          "resource": "http://terminology.hl7.org/CodeSystem/condition-ver-status"
        },
        {
          "type": "depends-on",
          "display": "Value set Pap Test",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"
        },
        {
          "type": "depends-on",
          "display": "Value set HPV Test",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"
        },
        {
          "type": "depends-on",
          "display": "Value set Office Visit",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
        },
        {
          "type": "depends-on",
          "display": "Value set Preventive Care Services Established Office Visit, 18 and Up",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
        },
        {
          "type": "depends-on",
          "display": "Value set Preventive Care Services Initial Office Visit, 18 and Up",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
        },
        {
          "type": "depends-on",
          "display": "Value set Home Healthcare Services",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
        },
        {
          "type": "depends-on",
          "display": "Value set Telephone Visits",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"
        },
        {
          "type": "depends-on",
          "display": "Value set Virtual Encounter",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"
        },
        {
          "type": "depends-on",
          "display": "Value set Payer Type",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type": "depends-on",
          "display": "Value set Encounter Inpatient",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
        },
        {
          "type": "depends-on",
          "display": "Value set Hospice Encounter",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"
        },
        {
          "type": "depends-on",
          "display": "Value set Hospice Care Ambulatory",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"
        },
        {
          "type": "depends-on",
          "display": "Value set Hospice Diagnosis",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"
        },
        {
          "type": "depends-on",
          "display": "Value set Hysterectomy with No Residual Cervix",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014"
        },
        {
          "type": "depends-on",
          "display": "Value set Congenital or Acquired Absence of Cervix",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1016"
        },
        {
          "type": "depends-on",
          "display": "Value set Palliative Care Diagnosis",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"
        },
        {
          "type": "depends-on",
          "display": "Value set Palliative Care Encounter",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090"
        },
        {
          "type": "depends-on",
          "display": "Value set Palliative Care Intervention",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "Numerator",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Denominator",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Denominator Exclusions",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "SDE Sex",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "name": "SDE Payer",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Resource"
        },
        {
          "name": "SDE Ethnicity",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Resource"
        },
        {
          "name": "SDE Race",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Resource"
        }
      ],
      "dataRequirement": [
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
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        },
        {
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      ]
    }
  ],
  "extension": [
    {
      "id": "supplementalDataGuidance",
      "extension": [
        {
          "url": "guidance",
          "valueString": "For every patient evaluated by this measure also identify payer, race, ethnicity and sex"
        },
        {
          "url": "usage",
          "valueCodeableConcept": {
            "coding": [
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                "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                "code": "supplemental-data",
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              }
            ],
            "text": "Supplemental Data Guidance"
          }
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueReference": {
        "reference": "#effective-data-requirements"
      }
    }
  ],
  "url": "https://madie.cms.gov/Measure/CMS124FHIRCervicalCancerScreening",
  "identifier": [
    {
      "use": "usual",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "short-name",
            "display": "Short Name"
          }
        ]
      },
      "system": "https://madie.cms.gov/measure/shortName",
      "value": "CMS124FHIR"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-independent",
            "display": "Version Independent"
          }
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      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:3be5df74-24e1-46ed-b899-6e98b9e3760b"
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    {
      "use": "official",
      "type": {
        "coding": [
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            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-specific",
            "display": "Version Specific"
          }
        ]
      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:d5fb530b-1d57-424b-a8e2-3ef76f0f30c2"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "publisher",
            "display": "Publisher"
          }
        ]
      },
      "system": "https://madie.cms.gov/measure/cmsId",
      "value": "124FHIR",
      "assigner": {
        "display": "CMS"
      }
    }
  ],
  "version": "0.4.000",
  "name": "CMS124FHIRCervicalCancerScreening",
  "title": "Cervical Cancer ScreeningFHIR",
  "status": "active",
  "experimental": false,
  "date": "2025-06-27T21:16:57+00:00",
  "publisher": "National Committee for Quality Assurance",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.ncqa.org/"
        }
      ]
    }
  ],
  "description": "Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed within the last 3 years - Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years",
  "usage": "To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.  Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria.  Evidence of hrHPV testing within the last 5 years also captures patients who had cotesting; therefore additional methods to identify cotesting are not necessary.  This eCQM is a patient-based measure.  This FHIR-based measure has been derived from the QDM-based measure: CMS124v14.  Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).",
  "copyright": "This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved.  Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications.  CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use.  Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/.  This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation.   ICD-10 copyright 2025 World Health Organization. All Rights Reserved.  Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product.  “HL7” is the registered trademark of Health Level Seven International.",
  "effectivePeriod": {
    "start": "2026-01-01",
    "end": "2026-12-31"
  },
  "author": [
    {
      "name": "National Committee for Quality Assurance",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.ncqa.org/"
        }
      ]
    }
  ],
  "relatedArtifact": [
    {
      "type": "citation",
      "citation": "CITATION - American Cancer Society. (2020). Cancer Facts & Figures 2020. Atlanta: American Cancer Society. "
    },
    {
      "type": "citation",
      "citation": "CITATION - National Cancer Institute. (2020). Cancer of the Cervix Uteri - Cancer Stat Facts. https://seer.cancer.gov/statfacts/html/cervix.html "
    },
    {
      "type": "citation",
      "citation": "CITATION - US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., … Wong, J. B. (2018). Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 320(7), 674–686. https://doi.org/10.1001/jama.2018.10897 "
    }
  ],
  "library": [
    "https://madie.cms.gov/Library/CMS124FHIRCervicalCancerScreening"
  ],
  "disclaimer": "The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.   Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
  "rationale": "All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).",
  "clinicalRecommendationStatement": "The U.S Preventive Services Task Force (USPSTF) recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) (A recommendation) (USPSTF, 2018).  The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer (D recommendation) (USPSTF, 2018).  The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) (USPSTF, 2018).  The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion (i.e., cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer (D recommendation) (USPSTF, 2018).",
  "group": [
    {
      "id": "Group_1",
      "extension": [
        {
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          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
                "code": "proportion",
                "display": "Proportion"
              }
            ]
          }
        },
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
          "valueCode": "boolean"
        },
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
          "valueCodeableConcept": {
            "coding": [
              {
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                "code": "process",
                "display": "Process"
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        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
          "valueCode": "None"
        },
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
          "valueCodeableConcept": {
            "coding": [
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                "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                "code": "increase",
                "display": "Increased score indicates improvement"
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      "population": [
        {
          "id": "InitialPopulation_1",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "description": "Women 24-64 years of age by the end of the measurement period with a visit during the measurement period",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "id": "Denominator_1",
          "code": {
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                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "description": "Equals Initial Population",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        },
        {
          "id": "DenominatorExclusion_1",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator-exclusion",
                "display": "Denominator Exclusion"
              }
            ]
          },
          "description": "Exclude patients who are in hospice care for any part of the measurement period.  Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.  Exclude patients receiving palliative care for any part of the measurement period.",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator Exclusions"
          }
        },
        {
          "id": "Numerator_1",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "description": "Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria: - Cervical cytology performed during the measurement period or the two years prior to the measurement period for women 24-64 years of age by the end of the measurement period.  - Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Numerator"
          }
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "id": "sde-ethnicity",
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "SDE Ethnicity",
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Ethnicity"
      }
    },
    {
      "id": "sde-payer",
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "SDE Payer",
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Payer"
      }
    },
    {
      "id": "sde-race",
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "SDE Race",
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Race"
      }
    },
    {
      "id": "sde-sex",
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "SDE Sex",
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Sex"
      }
    }
  ]
}