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Package gov.healthit.ecqi.ecqms
Type Measure
Id Id
FHIR Version R4
Source http://ecqi.healthit.gov/ecqms/https://build.fhir.org/ig/cqframework/ecqm-content-qicore-2024/Measure-WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR.html
Url https://madie.cms.gov/Measure/WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR
Version 0.1.001
Status draft
Date 2024-12-16T18:17:09+00:00
Name WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR
Title Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR
Experimental False
Description Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity
Purpose UNKNOWN
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 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 can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 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 2024. 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) (http://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 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 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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Title: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR
Id: WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR
Version: 0.1.001
Url: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR
short-name identifier:

CMS155FHIR

version-independent identifier:

urn:uuid:ced3e428-2d50-4738-badb-3693cb0df02c

version-specific identifier:

urn:uuid:d139ed55-8531-4c25-ac6a-6242e1e1dc36

publisher (CMS) identifier:

155FHIR

Effective Period: 2025-01-01..2025-12-31
Status: draft
Publisher: National Committee for Quality Assurance
Author: National Committee for Quality Assurance
Description:

Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period.

  • Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
  • Percentage of patients with counseling for nutrition
  • Percentage of patients with counseling for physical activity
Purpose:

UNKNOWN
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 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 can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 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 2024. 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) (http://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 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use.

This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation.

ICD-10 copyright 2024 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].
Scoring:

Proportion

Rationale:

Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017).

Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention [CDC], 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (CDC, 2016).

The direct medical costs associated with childhood obesity total $1.32 billion per year (Ward et al., 2021).

Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).
Clinical recommendation statement:

U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)

American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017)

  • Plot and assess BMI percentiles routinely for early recognition of overweight and obesity.
  • Assess barriers to healthy eating and physical activity.
  • Provide anticipatory guidance for nutrition and physical activity.
Guidance (Usage): The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure:/ CMS155v13. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).
Population Criteria: Stratifier Criteria:
66208f5e0f0a9077c1d5b508
Initial Population: Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Denominator: Equals Initial Population
Denominator Exclusion: Exclude patients who are in hospice care for any part of the measurement period. Patients who have a diagnosis of pregnancy during the measurement period.
Numerator: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period.
Stratum: Patients age 3-11 years at the end of the measurement period
Stratum: Patients age 12-17 years at the end of the measurement period
Stratifier Criteria:
66208f5e0f0a9077c1d5b509
Initial Population: Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Denominator: Equals Initial Population
Denominator Exclusion: Exclude patients who are in hospice care for any part of the measurement period. Patients who have a diagnosis of pregnancy during the measurement period.
Numerator: Patients who had counseling for nutrition during the measurement period.
Stratum: Report a total score, and each of the following strata: Stratum 1 - Patients age 3-11 years at the end of the measurement period
Stratum: Stratum 2 - Patients age 12-17 years at the end of the measurement period
Stratifier Criteria:
66208f5e0f0a9077c1d5b50a
Initial Population: Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Denominator: Equals Initial Population
Denominator Exclusion: Exclude patients who are in hospice care for any part of the measurement period. Patients who have a diagnosis of pregnancy during the measurement period.
Numerator: Patients who had counseling for physical activity during the measurement period.
Stratum: Report a total score, and each of the following strata: Stratum 1 - Patients age 3-11 years at the end of the measurement period
Stratum: Stratum 2 - Patients age 12-17 years at the end of the measurement period
Libraries:
WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR
Terminology and Other Dependencies:
  • Library/Status|1.8.000
  • Library/QICoreCommon|2.1.000
  • Library/FHIRHelpers|4.4.000
  • Library/Hospice|6.12.000
  • SNOMED CT (all versions)
  • Observation Category Codes
  • Logical Observation Identifiers, Names and Codes (LOINC)
  • Counseling for Physical Activity
  • Office Visit
  • Preventive Care Services-Individual Counseling
  • Preventive Care, Established Office Visit, 0 to 17
  • Preventive Care Services, Initial Office Visit, 0 to 17
  • Preventive Care Services - Group Counseling
  • Home Healthcare Services
  • Telephone Visits
  • Counseling for Nutrition
  • Encounter Inpatient
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
  • Hospice Care Ambulatory
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
  • Pregnancy
    		•
    Parameters:
    name use min max type
    Measurement Period In 0 1 Period
    Stratifaction 1 Out 0 1 boolean
    Numerator 3 Out 0 1 boolean
    Stratifaction 2 Out 0 1 boolean
    Denominator Out 0 1 boolean
    Numerator 1 Out 0 1 boolean
    Numerator 2 Out 0 1 boolean
    Initial Population Out 0 1 boolean
    Denominator Exclusions Out 0 1 boolean
    DataRequirements:
    Resource Type Resource Elements Valueset Name Valueset
    Patient(QICorePatient)
    Procedure(QICoreProcedure) code performed status status.value Counseling for Physical Activity Counseling for Physical Activity
    Procedure(QICoreProcedure) code performed status status.value Counseling for Nutrition Counseling for Nutrition
    Procedure(QICoreProcedure) code performed status status.value Hospice Care Ambulatory Hospice Care Ambulatory
    Encounter(QICoreEncounter) type status status.value period Office Visit Office Visit
    Encounter(QICoreEncounter) type status status.value period Preventive Care Services Individual Counseling Preventive Care Services-Individual Counseling
    Encounter(QICoreEncounter) type status status.value period Preventive Care, Established Office Visit, 0 to 17 Preventive Care, Established Office Visit, 0 to 17
    Encounter(QICoreEncounter) type status status.value period Preventive Care Services, Initial Office Visit, 0 to 17 Preventive Care Services, Initial Office Visit, 0 to 17
    Encounter(QICoreEncounter) type status status.value period Preventive Care Services Group Counseling Preventive Care Services - Group Counseling
    Encounter(QICoreEncounter) type status status.value period Home Healthcare Services Home Healthcare Services
    Encounter(QICoreEncounter) type status status.value period Telephone Visits Telephone Visits
    Encounter(QICoreEncounter) type hospitalization hospitalization.dischargeDisposition period status status.value Encounter Inpatient Encounter Inpatient
    Encounter(QICoreEncounter) type period status status.value Hospice Encounter http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
    Observation(Observation Body Mass Index Profile) effective value status status.value
    Observation(Observation Body Height Profile) effective value status status.value
    Observation(Observation Body Weight Profile) effective value status status.value
    Observation(QICoreObservation) code value effective status status.value category
    ServiceRequest(QICoreServiceRequest) code authoredOn authoredOn.value status status.value intent intent.value Hospice Care Ambulatory Hospice Care Ambulatory
    Condition(QICoreCondition) code Hospice Diagnosis http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
    Condition(QICoreCondition) code Pregnancy Pregnancy
    Direct Reference Codes:
    display code system
    Discharge to home for hospice care (procedure) 428361000124107 http://snomed.info/sct
    Discharge to healthcare facility for hospice care (procedure) 428371000124100 http://snomed.info/sct
    survey survey http://terminology.hl7.org/CodeSystem/observation-category
    Yes (qualifier value) 373066001 http://snomed.info/sct
    Hospice care [Minimum Data Set] 45755-6 http://loinc.org
    Logic Definitions:
    Group Scoring Population Criteria Expression
    66208f5e0f0a9077c1d5b508 Group scoring: proportion Measure scoring:

    Proportion

    Type:

    Process

    Rate Aggregation: None
    Improvement Notation:

    increase

    Initial Population 
    define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[3, 17]
    and exists ( "Qualifying Encounters" )
    Denominator 
    define "Denominator":
  "Initial Population"
    Denominator Exclusion 
    define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy Diagnosis Which Overlaps Measurement Period" )
    Numerator 
    define "Numerator 1":
  exists ( "BMI Percentile in Measurement Period" )
    and exists ( "Height in Measurement Period" )
    and exists ( "Weight in Measurement Period" )
    66208f5e0f0a9077c1d5b509 Group scoring: proportion Measure scoring:

    Proportion

    Type:

    Process

    Rate Aggregation: None
    Improvement Notation:

    increase

    Initial Population 
    define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[3, 17]
    and exists ( "Qualifying Encounters" )
    Denominator 
    define "Denominator":
  "Initial Population"
    Denominator Exclusion 
    define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy Diagnosis Which Overlaps Measurement Period" )
    Numerator 
    define "Numerator 2":
  exists ( ( [Procedure: "Counseling for Nutrition"] ).isInterventionPerformed ( ) ) NutritionCounseling
    where NutritionCounseling.performed.toInterval ( ) during day of "Measurement Period"
    66208f5e0f0a9077c1d5b50a Group scoring: proportion Measure scoring:

    Proportion

    Type:

    Process

    Rate Aggregation: None
    Improvement Notation:

    increase

    Initial Population 
    define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[3, 17]
    and exists ( "Qualifying Encounters" )
    Denominator 
    define "Denominator":
  "Initial Population"
    Denominator Exclusion 
    define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy Diagnosis Which Overlaps Measurement Period" )
    Numerator 
    define "Numerator 3":
  exists ( ( [Procedure: "Counseling for Physical Activity"] ).isInterventionPerformed ( ) ) ActivityCounseling
    where ActivityCounseling.performed.toInterval ( ) during day of "Measurement Period"
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Stratifaction 1 
    define "Stratifaction 1":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[3, 11]
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Numerator 3 
    define "Numerator 3":
  exists ( ( [Procedure: "Counseling for Physical Activity"] ).isInterventionPerformed ( ) ) ActivityCounseling
    where ActivityCounseling.performed.toInterval ( ) during day of "Measurement Period"
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Stratifaction 2 
    define "Stratifaction 2":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[12, 17]
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Qualifying Encounters 
    define "Qualifying Encounters":
  ( ( [Encounter: "Office Visit"]
      union [Encounter: "Preventive Care Services Individual Counseling"]
      union [Encounter: "Preventive Care, Established Office Visit, 0 to 17"]
      union [Encounter: "Preventive Care Services, Initial Office Visit, 0 to 17"]
      union [Encounter: "Preventive Care Services Group Counseling"]
      union [Encounter: "Home Healthcare Services"]
      union [Encounter: "Telephone Visits"]
  ).isEncounterPerformed ( ) ) ValidEncounters
    where ValidEncounters.period.toInterval ( ) during day of "Measurement Period"
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Initial Population 
    define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) in Interval[3, 17]
    and exists ( "Qualifying Encounters" )
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Denominator 
    define "Denominator":
  "Initial Population"
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR BMI Percentile in Measurement Period 
    define "BMI Percentile in Measurement Period":
  ( ( ["observation-bmi"] ).isObservationBMI ( ) ) BMIPercentile
    where BMIPercentile.effective.toInterval ( ) during day of "Measurement Period"
      and BMIPercentile.value is not null
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Height in Measurement Period 
    define "Height in Measurement Period":
  ( ( ["observation-bodyheight"] ).isObservationBodyHeight ( ) ) Height
    where Height.effective.toInterval ( ) during day of "Measurement Period"
      and Height.value is not null
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Weight in Measurement Period 
    define "Weight in Measurement Period":
  ( ( ["observation-bodyweight"] ).isObservationBodyWeight ( ) ) Weight
    where Weight.effective.toInterval ( ) during day of "Measurement Period"
      and Weight.value is not null
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Numerator 1 
    define "Numerator 1":
  exists ( "BMI Percentile in Measurement Period" )
    and exists ( "Height in Measurement Period" )
    and exists ( "Weight in Measurement Period" )
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Numerator 2 
    define "Numerator 2":
  exists ( ( [Procedure: "Counseling for Nutrition"] ).isInterventionPerformed ( ) ) NutritionCounseling
    where NutritionCounseling.performed.toInterval ( ) during day of "Measurement Period"
    Library Name Name
    Hospice Has Hospice Services 
    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.toInterval() ends during day of "Measurement Period"
  )
    or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
        where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"
    )
    or exists ((([Observation: "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.toInterval() during day of "Measurement Period"
        // and HospiceOrder.doNotPerform is not true
        // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
    )
    or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
        where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
    )
    or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis
        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
    )
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Pregnancy Diagnosis Which Overlaps Measurement Period 
    define "Pregnancy Diagnosis Which Overlaps Measurement Period":
  ( [Condition: "Pregnancy"] ) Pregnancy
    where Pregnancy.prevalenceInterval ( ) overlaps "Measurement Period"
    Library Name Name
    WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR Denominator Exclusions 
    define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy Diagnosis Which Overlaps Measurement Period" )
    Library Name Name
    Status isInterventionPerformed 
    //Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
  Proc P
    where P.status ~ 'completed'
    Library Name Name
    Status isEncounterPerformed 
    //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 in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}
    Library Name Name
    QICoreCommon toInterval 
    /*
@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
    Library Name Name
    Status isObservationBMI 
    define fluent function isObservationBMI(Obs List<"QICore.observation-bmi">):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }
    Library Name Name
    Status isObservationBodyHeight 
    define fluent function isObservationBodyHeight(Obs List<"QICore.observation-bodyheight">):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }
    Library Name Name
    Status isObservationBodyWeight 
    define fluent function isObservationBodyWeight(Obs List<"QICore.observation-bodyweight">):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }
    Library Name Name
    Status isAssessmentPerformed 
    //This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.

//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<Observation>):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }
          and exists ( O.category ObservationCategory
          where ( ObservationCategory ) ~ "survey"
      )
    Library Name Name
    FHIRHelpers ToConcept 
    /*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
    Library Name Name
    Status isInterventionOrder 
    //Intervention, Order: active and completed only    
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
  ServiceRequest S
    where S.status in { 'active', 'completed' }
      and S.intent = 'order'
    Library Name Name
    QICoreCommon prevalenceInterval 
    /*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]

    Source

    {
      "resourceType" : "Measure",
      "id" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR",
      "meta" : {
        "profile" : [
          "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"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n            <tr>\n                <th scope=\"row\"><b>Title: </b></th>\n                <td style=\"padding-left: 4px;\">Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR</td>\n            </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Id: </b></th>\n                <td style=\"padding-left: 4px;\">WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Version: </b></th>\n                <td style=\"padding-left: 4px;\">0.1.001</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Url: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Measure-WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR.html\">Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR</a></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\">\n                    <b>\n                        \n                            \n                                short-name identifier:\n                            \n                        \n                    </b>\n                </th>\n\n                <td style=\"padding-left: 4px;\">\n                    \n                        <p style=\"margin-bottom: 5px;\">\n                            <span>CMS155FHIR</span>\n                        </p>\n                    \n                </td>\n            </tr>\n        \n            <tr>\n                <th scope=\"row\">\n                    <b>\n                        \n                            \n                                version-independent identifier:\n                            \n                        \n                    </b>\n                </th>\n\n                <td style=\"padding-left: 4px;\">\n                    \n                        <p style=\"margin-bottom: 5px;\">\n                            <span>urn:uuid:ced3e428-2d50-4738-badb-3693cb0df02c</span>\n                        </p>\n                    \n                </td>\n            </tr>\n        \n            <tr>\n                <th scope=\"row\">\n                    <b>\n                        \n                            \n                                version-specific identifier:\n                            \n                        \n                    </b>\n                </th>\n\n                <td style=\"padding-left: 4px;\">\n                    \n                        <p style=\"margin-bottom: 5px;\">\n                            <span>urn:uuid:d139ed55-8531-4c25-ac6a-6242e1e1dc36</span>\n                        </p>\n                    \n                </td>\n            </tr>\n        \n            <tr>\n                <th scope=\"row\">\n                    <b>\n                        \n                            \n                                publisher (CMS) identifier:\n                            \n                        \n                    </b>\n                </th>\n\n                <td style=\"padding-left: 4px;\">\n                    \n                        <p style=\"margin-bottom: 5px;\">\n                            <span>155FHIR</span>\n                        </p>\n                    \n                </td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Effective Period: </b></th>\n                <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Status: </b></th>\n                <td style=\"padding-left: 4px;\">draft</td>\n            </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Publisher: </b></th>\n                <td style=\"padding-left: 4px;\">National Committee for Quality Assurance</td>\n            </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Author: </b></th>\n            <td style=\"padding-left: 4px;\">National Committee for Quality Assurance</td>\n        </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Description: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period.</p>\n<ul>\n<li>Percentage of patients with height, weight, and body mass index (BMI) percentile documentation</li>\n<li>Percentage of patients with counseling for nutrition</li>\n<li>Percentage of patients with counseling for physical activity</li>\n</ul>\n</div></td>\n            </tr>\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Purpose: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Copyright: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>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 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 can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 National Committee for Quality Assurance. All Rights Reserved.</p>\n<p>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.</p>\n<p>CPT(R) codes, descriptions and other data are copyright 2024. 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.</p>\n<p>Some measure specifications contain coding from LOINC(R) (http://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 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use.</p>\n<p>This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation.</p>\n<p>ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p>\n<p>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.</p>\n<p>“HL7” is the registered trademark of Health Level Seven International.</p>\n</div></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Disclaimer: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>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 &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n            </tr>\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Scoring: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                                <span>Proportion </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Rationale: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, &amp; Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017).</p>\n<p>Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention [CDC], 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (CDC, 2016).</p>\n<p>The direct medical costs associated with childhood obesity total $1.32 billion per year (Ward et al., 2021).</p>\n<p>Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).</p>\n</div></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)</p>\n<p>American Academy of Pediatrics – Bright Futures (Hagan, Shaw, &amp; Duncan, 2017)</p>\n<ul>\n<li>Plot and assess BMI percentiles routinely for early recognition of overweight and obesity.</li>\n<li>Assess barriers to healthy eating and physical activity.</li>\n<li>Provide anticipatory guidance for nutrition and physical activity.</li>\n</ul>\n</div></td>\n        </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Guidance (Usage): </b></th>\n                <td style=\"padding-left: 4px;\">The visit must be performed by a PCP or OB/GYN. \nBecause BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.\n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure:/ CMS155v13.\n\nPlease refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n            </tr>\n        \n\n        \n            \n                <tr>\n                    <th scope=\"row\"><b>Population Criteria: </b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                            <table class=\"grid-dict\">\n                                \n                                    <tr>\n                                        <th><b>66208f5e0f0a9077c1d5b508</b></th>\n                                    </tr>\n                                \n                                \n                                    <tr>\n                                        <td>Initial Population:</td>\n\n                                        \n                                            \n                                                <td>Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator:</td>\n\n                                        \n                                            \n                                                <td>Equals Initial Population</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator Exclusion:</td>\n\n                                        \n                                            \n                                                <td>Exclude patients who are in hospice care for any part of the measurement period.\n\nPatients who have a diagnosis of pregnancy during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Numerator:</td>\n\n                                        \n                                            \n                                                <td>Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                \n                                  <tr><b>Stratifier Criteria: </b></tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Patients age 3-11 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Patients age 12-17 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                \n                            </table>\n                        \n                            <table class=\"grid-dict\">\n                                \n                                    <tr>\n                                        <th><b>66208f5e0f0a9077c1d5b509</b></th>\n                                    </tr>\n                                \n                                \n                                    <tr>\n                                        <td>Initial Population:</td>\n\n                                        \n                                            \n                                                <td>Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator:</td>\n\n                                        \n                                            \n                                                <td>Equals Initial Population</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator Exclusion:</td>\n\n                                        \n                                            \n                                                <td>Exclude patients who are in hospice care for any part of the measurement period.\n\nPatients who have a diagnosis of pregnancy during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Numerator:</td>\n\n                                        \n                                            \n                                                <td>Patients who had counseling for nutrition during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                \n                                  <tr><b>Stratifier Criteria: </b></tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Report a total score, and each of the following strata:\nStratum 1 - Patients age 3-11 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Stratum 2 - Patients age 12-17 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                \n                            </table>\n                        \n                            <table class=\"grid-dict\">\n                                \n                                    <tr>\n                                        <th><b>66208f5e0f0a9077c1d5b50a</b></th>\n                                    </tr>\n                                \n                                \n                                    <tr>\n                                        <td>Initial Population:</td>\n\n                                        \n                                            \n                                                <td>Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator:</td>\n\n                                        \n                                            \n                                                <td>Equals Initial Population</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Denominator Exclusion:</td>\n\n                                        \n                                            \n                                                <td>Exclude patients who are in hospice care for any part of the measurement period.\n\nPatients who have a diagnosis of pregnancy during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Numerator:</td>\n\n                                        \n                                            \n                                                <td>Patients who had counseling for physical activity during the measurement period.</td>\n                                            \n                                        \n\n                                    </tr>\n                                \n                                \n                                  <tr><b>Stratifier Criteria: </b></tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Report a total score, and each of the following strata:\nStratum 1 - Patients age 3-11 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                        <tr>\n                                            \n                                                <td>Stratum:</td>\n                                            \n\n                                            \n                                                <td>Stratum 2 - Patients age 12-17 years at the end of the measurement period</td>\n                                            \n                                        </tr>\n                                    \n                                \n                            </table>\n                        \n                    </td>\n                </tr>\n            \n        \n\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Libraries: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        \n                            <tr>\n                                <td><a href=\"Library-WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR.html\">WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</a></td>\n                            </tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n\n        \n\n        \n            \n                <tr>\n                    <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                            <li><code>Library/Status|1.8.000</code></li>\n                        \n                            <li><code>Library/QICoreCommon|2.1.000</code></li>\n                        \n                            <li><code>Library/FHIRHelpers|4.4.000</code></li>\n                        \n                            <li><code>Library/Hospice|6.12.000</code></li>\n                        \n                            <li><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></li>\n                        \n                            <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">Observation Category Codes</a></li>\n                        \n                            <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1035/expansion\">Counseling for Physical Activity</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1026/expansion\">Preventive Care Services-Individual Counseling</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1024/expansion\">Preventive Care, Established Office Visit, 0 to 17</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1022/expansion\">Preventive Care Services, Initial Office Visit, 0 to 17</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1027/expansion\">Preventive Care Services - Group Counseling</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion\">Telephone Visits</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.195.12.1003/expansion\">Counseling for Nutrition</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a></li>\n                        \n                    </td>\n                </tr>\n                <tr>\n                    <th scope=\"row\"><b>Parameters:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>name</b></th>\n                                <th><b>use</b></th>\n                                <th><b>min</b></th>\n                                <th><b>max</b></th>\n                                <th><b>type</b></th>\n                            </tr>\n                            \n                                <tr>\n                                    <td>Measurement Period</td>\n                                    <td>In</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Period</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifaction 1</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Numerator 3</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifaction 2</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Numerator 1</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Numerator 2</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Initial Population</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator Exclusions</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n\n                <tr>\n                    <th scope=\"row\"><b>DataRequirements:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>Resource Type</b></th>\n                                <th><b>Resource Elements</b></th>\n                                <th><b>Valueset Name</b></th>\n                                <th><b>Valueset</b></th>\n                            </tr>\n                            \n                                <tr>\n                                    <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Counseling for Physical Activity\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1035/expansion\">Counseling for Physical Activity</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Counseling for Nutrition\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.195.12.1003/expansion\">Counseling for Nutrition</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice Care Ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Office Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services Individual Counseling\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1026/expansion\">Preventive Care Services-Individual Counseling</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care, Established Office Visit, 0 to 17\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1024/expansion\">Preventive Care, Established Office Visit, 0 to 17</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services, Initial Office Visit, 0 to 17\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1022/expansion\">Preventive Care Services, Initial Office Visit, 0 to 17</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services Group Counseling\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1027/expansion\">Preventive Care Services - Group Counseling</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Home Healthcare Services\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Telephone Visits\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion\">Telephone Visits</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            hospitalization\n                                        \n                                            hospitalization.dischargeDisposition\n                                        \n                                            period\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Encounter Inpatient\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            period\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice Encounter\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Observation(<a href=\"http://hl7.org/fhir/R4/bmi.html\">Observation Body Mass Index Profile</a>)</td>\n                                    <td>\n                                        \n                                            effective\n                                        \n                                            value\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Observation(<a href=\"http://hl7.org/fhir/R4/bodyheight.html\">Observation Body Height Profile</a>)</td>\n                                    <td>\n                                        \n                                            effective\n                                        \n                                            value\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Observation(<a href=\"http://hl7.org/fhir/R4/bodyweight.html\">Observation Body Weight Profile</a>)</td>\n                                    <td>\n                                        \n                                            effective\n                                        \n                                            value\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            value\n                                        \n                                            effective\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            category\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            authoredOn\n                                        \n                                            authoredOn.value\n                                        \n                                            status\n                                        \n                                            status.value\n                                        \n                                            intent\n                                        \n                                            intent.value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice Care Ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice Diagnosis\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Pregnancy\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a></td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n\n                \n                    <tr>\n                        <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            <table class=\"grid-dict\">\n                                <tr>\n                                    <th><b>display</b></th>\n                                    <th><b>code</b></th>\n                                    <th><b>system</b></th>\n                                </tr>\n                                \n                                    <tr>\n                                        <td>Discharge to home for hospice care (procedure)</td>\n                                        <td>428361000124107</td>\n                                        <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Discharge to healthcare facility for hospice care (procedure)</td>\n                                        <td>428371000124100</td>\n                                        <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>survey</td>\n                                        <td>survey</td>\n                                        <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">http://terminology.hl7.org/CodeSystem/observation-category</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Yes (qualifier value)</td>\n                                        <td>373066001</td>\n                                        <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Hospice care [Minimum Data Set]</td>\n                                        <td>45755-6</td>\n                                        <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n\n                \n                <tr>\n                    <th scope=\"row\"><b>Logic Definitions:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>Group</b></th>\n                                <th><b>Scoring</b></th>\n                                <th><b>Population Criteria</b></th>\n                                <th><b>Expression</b></th>\n                            </tr>\n                            <tr>\n                                \n                                <td> 66208f5e0f0a9077c1d5b508 </td>\n                                <td colspan=\"3\" style=\"padding-left: 4px;\">\n                                    \n                                        <b>Group scoring:</b>\n                                        \n                                            <span>  proportion </span>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <b>Measure scoring:</b>\n                                        \n                                            <p style=\"margin-bottom: 5px;\">\n                                                <span>Proportion</span>\n                                            </p>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <tr>\n                                        \n                                            <th scope=\"row\"><b>Type: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>Process </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            </td>\n                                        \n                                        </tr>\n                                    \n\n                                    \n\n                                    \n                                    <tr>\n                                        <th scope=\"row\"><b>Rate Aggregation: </b></th>\n                                        <td colspan=\"3\" style=\"padding-left: 4px;\">None</td>\n                                    </tr>\n                                    \n\n                                    \n                                        <tr>\n                                            <th scope=\"row\"><b>Improvement Notation: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                            \n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>increase </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            \n                                            </td>\n                                        </tr>\n                                    \n\n                                    \n\n                                </td>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Initial Population</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[3, 17]\n    and exists ( &quot;Qualifying Encounters&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator Exclusion</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  Hospice.&quot;Has Hospice Services&quot;\n    or exists ( &quot;Pregnancy Diagnosis Which Overlaps Measurement Period&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Numerator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Numerator 1&quot;:\n  exists ( &quot;BMI Percentile in Measurement Period&quot; )\n    and exists ( &quot;Height in Measurement Period&quot; )\n    and exists ( &quot;Weight in Measurement Period&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                            \n                                <td> 66208f5e0f0a9077c1d5b509 </td>\n                                <td colspan=\"3\" style=\"padding-left: 4px;\">\n                                    \n                                        <b>Group scoring:</b>\n                                        \n                                            <span>  proportion </span>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <b>Measure scoring:</b>\n                                        \n                                            <p style=\"margin-bottom: 5px;\">\n                                                <span>Proportion</span>\n                                            </p>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <tr>\n                                        \n                                            <th scope=\"row\"><b>Type: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>Process </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            </td>\n                                        \n                                        </tr>\n                                    \n\n                                    \n\n                                    \n                                    <tr>\n                                        <th scope=\"row\"><b>Rate Aggregation: </b></th>\n                                        <td colspan=\"3\" style=\"padding-left: 4px;\">None</td>\n                                    </tr>\n                                    \n\n                                    \n                                        <tr>\n                                            <th scope=\"row\"><b>Improvement Notation: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                            \n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>increase </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            \n                                            </td>\n                                        </tr>\n                                    \n\n                                    \n\n                                </td>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Initial Population</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[3, 17]\n    and exists ( &quot;Qualifying Encounters&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator Exclusion</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  Hospice.&quot;Has Hospice Services&quot;\n    or exists ( &quot;Pregnancy Diagnosis Which Overlaps Measurement Period&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Numerator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Numerator 2&quot;:\n  exists ( ( [Procedure: &quot;Counseling for Nutrition&quot;] ).isInterventionPerformed ( ) ) NutritionCounseling\n    where NutritionCounseling.performed.toInterval ( ) during day of &quot;Measurement Period&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                            \n                                <td> 66208f5e0f0a9077c1d5b50a </td>\n                                <td colspan=\"3\" style=\"padding-left: 4px;\">\n                                    \n                                        <b>Group scoring:</b>\n                                        \n                                            <span>  proportion </span>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <b>Measure scoring:</b>\n                                        \n                                            <p style=\"margin-bottom: 5px;\">\n                                                <span>Proportion</span>\n                                            </p>\n                                        \n                                    \n\n                                    \n\n                                    \n                                        <tr>\n                                        \n                                            <th scope=\"row\"><b>Type: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>Process </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            </td>\n                                        \n                                        </tr>\n                                    \n\n                                    \n\n                                    \n                                    <tr>\n                                        <th scope=\"row\"><b>Rate Aggregation: </b></th>\n                                        <td colspan=\"3\" style=\"padding-left: 4px;\">None</td>\n                                    </tr>\n                                    \n\n                                    \n                                        <tr>\n                                            <th scope=\"row\"><b>Improvement Notation: </b></th>\n                                            <td style=\"padding-left: 4px;\">\n                                            \n                                                \n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                            <span>increase </span>\n                                                        </p>\n                                                    \n                                                \n                                                \n                                            \n                                            </td>\n                                        </tr>\n                                    \n\n                                    \n\n                                </td>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Initial Population</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[3, 17]\n    and exists ( &quot;Qualifying Encounters&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator Exclusion</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  Hospice.&quot;Has Hospice Services&quot;\n    or exists ( &quot;Pregnancy Diagnosis Which Overlaps Measurement Period&quot; )</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Numerator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Numerator 3&quot;:\n  exists ( ( [Procedure: &quot;Counseling for Physical Activity&quot;] ).isInterventionPerformed ( ) ) ActivityCounseling\n    where ActivityCounseling.performed.toInterval ( ) during day of &quot;Measurement Period&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                            \n                            </tr>\n                        </table>\n                \n\n                <table class=\"grid-dict\">\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Stratifaction 1</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifaction 1&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[3, 11]</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Numerator 3</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator 3&quot;:\n  exists ( ( [Procedure: &quot;Counseling for Physical Activity&quot;] ).isInterventionPerformed ( ) ) ActivityCounseling\n    where ActivityCounseling.performed.toInterval ( ) during day of &quot;Measurement Period&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Stratifaction 2</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifaction 2&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[12, 17]</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Qualifying Encounters</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Qualifying Encounters&quot;:\n  ( ( [Encounter: &quot;Office Visit&quot;]\n      union [Encounter: &quot;Preventive Care Services Individual Counseling&quot;]\n      union [Encounter: &quot;Preventive Care, Established Office Visit, 0 to 17&quot;]\n      union [Encounter: &quot;Preventive Care Services, Initial Office Visit, 0 to 17&quot;]\n      union [Encounter: &quot;Preventive Care Services Group Counseling&quot;]\n      union [Encounter: &quot;Home Healthcare Services&quot;]\n      union [Encounter: &quot;Telephone Visits&quot;]\n  ).isEncounterPerformed ( ) ) ValidEncounters\n    where ValidEncounters.period.toInterval ( ) during day of &quot;Measurement Period&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Initial Population</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AgeInYearsAt(date from \n    end of &quot;Measurement Period&quot;\n  ) in Interval[3, 17]\n    and exists ( &quot;Qualifying Encounters&quot; )</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Denominator</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>BMI Percentile in Measurement Period</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;BMI Percentile in Measurement Period&quot;:\n  ( ( [&quot;observation-bmi&quot;] ).isObservationBMI ( ) ) BMIPercentile\n    where BMIPercentile.effective.toInterval ( ) during day of &quot;Measurement Period&quot;\n      and BMIPercentile.value is not null</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Height in Measurement Period</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Height in Measurement Period&quot;:\n  ( ( [&quot;observation-bodyheight&quot;] ).isObservationBodyHeight ( ) ) Height\n    where Height.effective.toInterval ( ) during day of &quot;Measurement Period&quot;\n      and Height.value is not null</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Weight in Measurement Period</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Weight in Measurement Period&quot;:\n  ( ( [&quot;observation-bodyweight&quot;] ).isObservationBodyWeight ( ) ) Weight\n    where Weight.effective.toInterval ( ) during day of &quot;Measurement Period&quot;\n      and Weight.value is not null</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Numerator 1</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator 1&quot;:\n  exists ( &quot;BMI Percentile in Measurement Period&quot; )\n    and exists ( &quot;Height in Measurement Period&quot; )\n    and exists ( &quot;Weight in Measurement Period&quot; )</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Numerator 2</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator 2&quot;:\n  exists ( ( [Procedure: &quot;Counseling for Nutrition&quot;] ).isInterventionPerformed ( ) ) NutritionCounseling\n    where NutritionCounseling.performed.toInterval ( ) during day of &quot;Measurement Period&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Hospice</td>\n                            \n                            \n                                <td>Has Hospice Services</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Has Hospice Services&quot;:\n  exists ((([Encounter: &quot;Encounter Inpatient&quot;]).isEncounterPerformed()) InpatientEncounter\n      where (InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;\n          or InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;\n      )\n        and InpatientEncounter.period.toInterval() ends during day of &quot;Measurement Period&quot;\n  )\n    or exists ((([Encounter: &quot;Hospice Encounter&quot;]).isEncounterPerformed()) HospiceEncounter\n        where HospiceEncounter.period.toInterval() overlaps day of &quot;Measurement Period&quot;\n    )\n    or exists ((([Observation: &quot;Hospice care [Minimum Data Set]&quot;]).isAssessmentPerformed()) HospiceAssessment\n        where HospiceAssessment.value ~ &quot;Yes (qualifier value)&quot;\n          and HospiceAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;\n    )\n    or exists ((([ServiceRequest: &quot;Hospice Care Ambulatory&quot;]).isInterventionOrder()) HospiceOrder\n        where HospiceOrder.authoredOn.toInterval() during day of &quot;Measurement Period&quot;\n        // and HospiceOrder.doNotPerform is not true\n        // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447\n    )\n    or exists ((([Procedure: &quot;Hospice Care Ambulatory&quot;]).isInterventionPerformed()) HospicePerformed\n        where HospicePerformed.performed.toInterval() overlaps day of &quot;Measurement Period&quot;\n    )\n    or exists (([Condition: &quot;Hospice Diagnosis&quot;]) HospiceCareDiagnosis\n        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;\n    )</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Pregnancy Diagnosis Which Overlaps Measurement Period</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Pregnancy Diagnosis Which Overlaps Measurement Period&quot;:\n  ( [Condition: &quot;Pregnancy&quot;] ) Pregnancy\n    where Pregnancy.prevalenceInterval ( ) overlaps &quot;Measurement Period&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR</td>\n                            \n                            \n                                <td>Denominator Exclusions</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  Hospice.&quot;Has Hospice Services&quot;\n    or exists ( &quot;Pregnancy Diagnosis Which Overlaps Measurement Period&quot; )</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isInterventionPerformed</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List&lt;Procedure&gt;):\n  Proc P\n    where P.status ~ 'completed'</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isEncounterPerformed</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List&lt;Encounter&gt;):\n  Enc E\n    where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>QICoreCommon</td>\n                            \n                            \n                                <td>toInterval</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval&lt;DateTime&gt; then\n  \t\tchoice as Interval&lt;DateTime&gt;\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval&lt;Quantity&gt; then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;\n\t\telse\n\t\t\tnull as Interval&lt;DateTime&gt;\n\tend</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isObservationBMI</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function isObservationBMI(Obs List&lt;&quot;QICore.observation-bmi&quot;&gt;):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isObservationBodyHeight</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function isObservationBodyHeight(Obs List&lt;&quot;QICore.observation-bodyheight&quot;&gt;):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isObservationBodyWeight</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function isObservationBodyWeight(Obs List&lt;&quot;QICore.observation-bodyweight&quot;&gt;):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isAssessmentPerformed</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.\n\n//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List&lt;Observation&gt;):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }\n          and exists ( O.category ObservationCategory\n          where ( ObservationCategory ) ~ &quot;survey&quot;\n      )</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>FHIRHelpers</td>\n                            \n                            \n                                <td>ToConcept</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>Status</td>\n                            \n                            \n                                <td>isInterventionOrder</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Intervention, Order: active and completed only    \ndefine fluent function isInterventionOrder(ServiceRequest List&lt;ServiceRequest&gt;):\n  ServiceRequest S\n    where S.status in { 'active', 'completed' }\n      and S.intent = 'order'</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>QICoreCommon</td>\n                            \n                            \n                                <td>prevalenceInterval</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ &quot;active&quot;\n  or condition.clinicalStatus ~ &quot;recurrence&quot;\n  or condition.clinicalStatus ~ &quot;relapse&quot; then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n    (end of condition.abatementInterval()) abatementDate\n    return if abatementDate is null then\n      Interval[start of condition.onset.toInterval(), abatementDate)\n    else\n      Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                    </table>\n                </td>\n            </tr>\n            \n        \n    \n\n    </table>\n</div>"
      },
      "contained" : [
        {
          "resourceType" : "Library",
          "id" : "effective-data-requirements",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "428361000124107",
                "display" : "Discharge to home for hospice care (procedure)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "428371000124100",
                "display" : "Discharge to healthcare facility for hospice care (procedure)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "survey",
                "display" : "survey"
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "373066001",
                "display" : "Yes (qualifier value)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "45755-6",
                "display" : "Hospice care [Minimum Data Set]"
              }
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Stratifaction 1"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Stratifaction 1\":\n  AgeInYearsAt(date from \n    end of \"Measurement Period\"\n  ) in Interval[3, 11]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 0
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Numerator 3"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Numerator 3\":\n  exists ( ( [Procedure: \"Counseling for Physical Activity\"] ).isInterventionPerformed ( ) ) ActivityCounseling\n    where ActivityCounseling.performed.toInterval ( ) during day of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 1
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Stratifaction 2"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Stratifaction 2\":\n  AgeInYearsAt(date from \n    end of \"Measurement Period\"\n  ) in Interval[12, 17]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 2
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Qualifying Encounters"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Qualifying Encounters\":\n  ( ( [Encounter: \"Office Visit\"]\n      union [Encounter: \"Preventive Care Services Individual Counseling\"]\n      union [Encounter: \"Preventive Care, Established Office Visit, 0 to 17\"]\n      union [Encounter: \"Preventive Care Services, Initial Office Visit, 0 to 17\"]\n      union [Encounter: \"Preventive Care Services Group Counseling\"]\n      union [Encounter: \"Home Healthcare Services\"]\n      union [Encounter: \"Telephone Visits\"]\n  ).isEncounterPerformed ( ) ) ValidEncounters\n    where ValidEncounters.period.toInterval ( ) during day of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 3
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Initial Population"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Initial Population\":\n  AgeInYearsAt(date from \n    end of \"Measurement Period\"\n  ) in Interval[3, 17]\n    and exists ( \"Qualifying Encounters\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 4
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator\":\n  \"Initial Population\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 5
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "BMI Percentile in Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"BMI Percentile in Measurement Period\":\n  ( ( [\"observation-bmi\"] ).isObservationBMI ( ) ) BMIPercentile\n    where BMIPercentile.effective.toInterval ( ) during day of \"Measurement Period\"\n      and BMIPercentile.value is not null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 6
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Height in Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Height in Measurement Period\":\n  ( ( [\"observation-bodyheight\"] ).isObservationBodyHeight ( ) ) Height\n    where Height.effective.toInterval ( ) during day of \"Measurement Period\"\n      and Height.value is not null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 7
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Weight in Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Weight in Measurement Period\":\n  ( ( [\"observation-bodyweight\"] ).isObservationBodyWeight ( ) ) Weight\n    where Weight.effective.toInterval ( ) during day of \"Measurement Period\"\n      and Weight.value is not null"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 8
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Numerator 1"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Numerator 1\":\n  exists ( \"BMI Percentile in Measurement Period\" )\n    and exists ( \"Height in Measurement Period\" )\n    and exists ( \"Weight in Measurement Period\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 9
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Numerator 2"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Numerator 2\":\n  exists ( ( [Procedure: \"Counseling for Nutrition\"] ).isInterventionPerformed ( ) ) NutritionCounseling\n    where NutritionCounseling.performed.toInterval ( ) during day of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 10
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Hospice"
                },
                {
                  "url" : "name",
                  "valueString" : "Has Hospice Services"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Has Hospice Services\":\n  exists ((([Encounter: \"Encounter Inpatient\"]).isEncounterPerformed()) InpatientEncounter\n      where (InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n          or InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n      )\n        and InpatientEncounter.period.toInterval() ends during day of \"Measurement Period\"\n  )\n    or exists ((([Encounter: \"Hospice Encounter\"]).isEncounterPerformed()) HospiceEncounter\n        where HospiceEncounter.period.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([Observation: \"Hospice care [Minimum Data Set]\"]).isAssessmentPerformed()) HospiceAssessment\n        where HospiceAssessment.value ~ \"Yes (qualifier value)\"\n          and HospiceAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists ((([ServiceRequest: \"Hospice Care Ambulatory\"]).isInterventionOrder()) HospiceOrder\n        where HospiceOrder.authoredOn.toInterval() during day of \"Measurement Period\"\n        // and HospiceOrder.doNotPerform is not true\n        // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447\n    )\n    or exists ((([Procedure: \"Hospice Care Ambulatory\"]).isInterventionPerformed()) HospicePerformed\n        where HospicePerformed.performed.toInterval() overlaps day of \"Measurement Period\"\n    )\n    or exists (([Condition: \"Hospice Diagnosis\"]) HospiceCareDiagnosis\n        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n    )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 11
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Pregnancy Diagnosis Which Overlaps Measurement Period"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Pregnancy Diagnosis Which Overlaps Measurement Period\":\n  ( [Condition: \"Pregnancy\"] ) Pregnancy\n    where Pregnancy.prevalenceInterval ( ) overlaps \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 12
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator Exclusions"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator Exclusions\":\n  Hospice.\"Has Hospice Services\"\n    or exists ( \"Pregnancy Diagnosis Which Overlaps Measurement Period\" )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 13
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isInterventionPerformed"
                },
                {
                  "url" : "statement",
                  "valueString" : "//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List<Procedure>):\n  Proc P\n    where P.status ~ 'completed'"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 14
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isEncounterPerformed"
                },
                {
                  "url" : "statement",
                  "valueString" : "//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List<Encounter>):\n  Enc E\n    where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 15
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "QICoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "toInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n  \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 16
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isObservationBMI"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function isObservationBMI(Obs List<\"QICore.observation-bmi\">):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 17
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isObservationBodyHeight"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function isObservationBodyHeight(Obs List<\"QICore.observation-bodyheight\">):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 18
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isObservationBodyWeight"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function isObservationBodyWeight(Obs List<\"QICore.observation-bodyweight\">):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 19
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isAssessmentPerformed"
                },
                {
                  "url" : "statement",
                  "valueString" : "//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.\n\n//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List<Observation>):\n  Obs O\n    where O.status in { 'final', 'amended', 'corrected' }\n          and exists ( O.category ObservationCategory\n          where ( ObservationCategory ) ~ \"survey\"\n      )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 20
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToConcept"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 21
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Status"
                },
                {
                  "url" : "name",
                  "valueString" : "isInterventionOrder"
                },
                {
                  "url" : "statement",
                  "valueString" : "//Intervention, Order: active and completed only    \ndefine fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):\n  ServiceRequest S\n    where S.status in { 'active', 'completed' }\n      and S.intent = 'order'"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 22
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "QICoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "prevalenceInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n  or condition.clinicalStatus ~ \"recurrence\"\n  or condition.clinicalStatus ~ \"relapse\" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n    (end of condition.abatementInterval()) abatementDate\n    return if abatementDate is null then\n      Interval[start of condition.onset.toInterval(), abatementDate)\n    else\n      Interval[start of condition.onset.toInterval(), abatementDate]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 23
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            }
          ],
          "name" : "EffectiveDataRequirements",
          "status" : "active",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/library-type",
                "code" : "module-definition"
              }
            ]
          },
          "relatedArtifact" : [
            {
              "type" : "depends-on",
              "display" : "Library Status",
              "resource" : "Library/Status|1.8.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library QICoreCommon",
              "resource" : "Library/QICoreCommon|2.1.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library FHIRHelpers",
              "resource" : "Library/FHIRHelpers|4.4.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library Hospice",
              "resource" : "Library/Hospice|6.12.000"
            },
            {
              "type" : "depends-on",
              "display" : "Code system SNOMEDCT",
              "resource" : "http://snomed.info/sct"
            },
            {
              "type" : "depends-on",
              "display" : "Code system ObservationCategoryCodes",
              "resource" : "http://terminology.hl7.org/CodeSystem/observation-category"
            },
            {
              "type" : "depends-on",
              "display" : "Code system LOINC",
              "resource" : "http://loinc.org"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Counseling for Physical Activity",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1035"
            },
            {
              "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 Individual Counseling",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preventive Care, Established Office Visit, 0 to 17",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preventive Care Services, Initial Office Visit, 0 to 17",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preventive Care Services Group Counseling",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027"
            },
            {
              "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 Counseling for Nutrition",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.195.12.1003"
            },
            {
              "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 Pregnancy",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378"
            }
          ],
          "parameter" : [
            {
              "name" : "Measurement Period",
              "use" : "in",
              "min" : 0,
              "max" : "1",
              "type" : "Period"
            },
            {
              "name" : "Stratifaction 1",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Numerator 3",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Stratifaction 2",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Denominator",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Numerator 1",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Numerator 2",
              "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"
            }
          ],
          "dataRequirement" : [
            {
              "type" : "Patient",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
              ],
              "mustSupport" : [
                "code",
                "performed",
                "status",
                "status.value"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1035"
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
              ],
              "mustSupport" : [
                "code",
                "performed",
                "status",
                "status.value"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.195.12.1003"
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
              ],
              "mustSupport" : [
                "code",
                "performed",
                "status",
                "status.value"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "status.value",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "status.value",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "status.value",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "status.value",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "status.value",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
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            {
              "type" : "Encounter",
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              "mustSupport" : [
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              "type" : "Encounter",
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                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
                "type",
                "hospitalization",
                "hospitalization.dischargeDisposition",
                "period",
                "status",
                "status.value"
              ],
              "codeFilter" : [
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            },
            {
              "type" : "Encounter",
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                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
              ],
              "mustSupport" : [
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                "period",
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              ],
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              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://hl7.org/fhir/StructureDefinition/bmi"
              ],
              "mustSupport" : [
                "effective",
                "value",
                "status",
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            {
              "type" : "Observation",
              "profile" : [
                "http://hl7.org/fhir/StructureDefinition/bodyheight"
              ],
              "mustSupport" : [
                "effective",
                "value",
                "status",
                "status.value"
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://hl7.org/fhir/StructureDefinition/bodyweight"
              ],
              "mustSupport" : [
                "effective",
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            {
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              ],
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                      "display" : "Hospice care [Minimum Data Set]"
                    }
                  ]
                },
                {
                  "path" : "value"
                }
              ]
            },
            {
              "type" : "ServiceRequest",
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      ],
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          "valueReference" : {
            "reference" : "Device/cqf-tooling"
          }
        },
        {
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          "valueReference" : {
            "reference" : "#effective-data-requirements"
          }
        }
      ],
      "url" : "https://madie.cms.gov/Measure/WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR",
      "identifier" : [
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "short-name"
              }
            ]
          },
          "system" : "https://madie.cms.gov/measure/shortName",
          "value" : "CMS155FHIR"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "version-independent"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:ced3e428-2d50-4738-badb-3693cb0df02c"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
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                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "version-specific"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:d139ed55-8531-4c25-ac6a-6242e1e1dc36"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "publisher"
              }
            ]
          },
          "system" : "https://madie.cms.gov/measure/cmsId",
          "value" : "155FHIR",
          "assigner" : {
            "display" : "CMS"
          }
        }
      ],
      "version" : "0.1.001",
      "name" : "WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR",
      "title" : "Weight Assessment and Counseling for Nutrition and Physical Activity for Children/AdolescentsFHIR",
      "status" : "draft",
      "experimental" : false,
      "date" : "2024-12-16T18:17:09+00:00",
      "publisher" : "National Committee for Quality Assurance",
      "contact" : [
        {
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.ncqa.org/"
            }
          ]
        }
      ],
      "description" : "Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period.\n\n - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation\n - Percentage of patients with counseling for nutrition\n - Percentage of patients with counseling for physical activity",
      "purpose" : "UNKNOWN",
      "usage" : "The visit must be performed by a PCP or OB/GYN. \nBecause BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.\n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure:/ CMS155v13.\n\nPlease refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/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 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 can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 National Committee for Quality Assurance. All Rights Reserved.\n\nLimited 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.\n\nCPT(R) codes, descriptions and other data are copyright 2024. 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.\n\nSome measure specifications contain coding from LOINC(R) (http://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 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use.\n\nThis material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. \n\nICD-10 copyright 2024 World Health Organization. All Rights Reserved.\n\nSome 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.\n\n“HL7” is the registered trademark of Health Level Seven International.",
      "effectivePeriod" : {
        "start" : "2025-01-01",
        "end" : "2025-12-31"
      },
      "author" : [
        {
          "name" : "National Committee for Quality Assurance",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.ncqa.org/"
            }
          ]
        }
      ],
      "library" : [
        "https://madie.cms.gov/Library/WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIR"
      ],
      "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.\n \nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
      "scoring" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion",
            "display" : "Proportion"
          }
        ]
      },
      "rationale" : "Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). \n\nChildhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention [CDC], 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (CDC, 2016). \n\nThe direct medical costs associated with childhood obesity total $1.32 billion per year (Ward et al., 2021).\n\nBecause obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).",
      "clinicalRecommendationStatement" : "U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)\n \nAmerican Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017)\n- Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. \n- Assess barriers to healthy eating and physical activity. \n- Provide anticipatory guidance for nutrition and physical activity.",
      "group" : [
        {
          "id" : "66208f5e0f0a9077c1d5b508",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
              "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" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "process",
                    "display" : "Process"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
              "valueCode" : "None"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease",
                    "display" : "increase"
                  }
                ]
              }
            }
          ],
          "population" : [
            {
              "id" : "7AEA838C-932D-4FD0-A6BA-64FAA99DA7EB",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "88DC2C1E-7B92-4A29-9A2A-3CF5F44F0068",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Equals Initial Population",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "C45EEBD2-B871-4436-9563-C0B4749DD23D",
              "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.\n\nPatients who have a diagnosis of pregnancy during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exclusions"
              }
            },
            {
              "id" : "B3E6F86E-25C1-4AB0-BEDB-523158706B13",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator 1"
              }
            }
          ],
          "stratifier" : [
            {
              "id" : "01baa358-389b-441d-8904-507cf58eabe1",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Patients age 3-11 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 1"
              }
            },
            {
              "id" : "bba1afe7-dcc0-4ce1-9c79-a7edeb324a26",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Patients age 12-17 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 2"
              }
            }
          ]
        },
        {
          "id" : "66208f5e0f0a9077c1d5b509",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
              "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" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "process",
                    "display" : "Process"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
              "valueCode" : "None"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease",
                    "display" : "increase"
                  }
                ]
              }
            }
          ],
          "population" : [
            {
              "id" : "D8000141-F25D-481B-8B90-065F9F800307",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "B2F1A49B-33FF-472B-92FC-C53FE3D0A0DA",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Equals Initial Population",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "02209FD7-7CED-4B6F-9417-2CF9793E7ABA",
              "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.\n\nPatients who have a diagnosis of pregnancy during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exclusions"
              }
            },
            {
              "id" : "7EBA88BE-0C83-4D8C-B12B-B94964EB5CF1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Patients who had counseling for nutrition during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator 2"
              }
            }
          ],
          "stratifier" : [
            {
              "id" : "40b3c5f0-1dd2-4db8-8966-e38dbe7f9bcb",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Report a total score, and each of the following strata:\nStratum 1 - Patients age 3-11 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 1"
              }
            },
            {
              "id" : "bc732fd9-d6d5-46e4-8030-9b376f429dd5",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Stratum 2 - Patients age 12-17 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 2"
              }
            }
          ]
        },
        {
          "id" : "66208f5e0f0a9077c1d5b50a",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
              "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" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "process",
                    "display" : "Process"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
              "valueCode" : "None"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease",
                    "display" : "increase"
                  }
                ]
              }
            }
          ],
          "population" : [
            {
              "id" : "7D7EDBF4-AEFB-477E-95C6-78A88081E73F",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "918E21DA-8F4E-42E4-BBA1-5EAD203995BB",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Equals Initial Population",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "E513C4C9-505F-40BC-A75B-363F1F83CECA",
              "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.\n\nPatients who have a diagnosis of pregnancy during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exclusions"
              }
            },
            {
              "id" : "DEA3D589-2511-4782-88CE-F98B3A1FC2AF",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Patients who had counseling for physical activity during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator 3"
              }
            }
          ],
          "stratifier" : [
            {
              "id" : "b8fea008-04c0-47b2-91b7-884593101333",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Report a total score, and each of the following strata:\nStratum 1 - Patients age 3-11 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 1"
              }
            },
            {
              "id" : "71ad32b1-915c-4292-b69b-71dbfa4a4579",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                        "code" : "initial-population",
                        "display" : "Initial Population"
                      }
                    ]
                  }
                }
              ],
              "description" : "Stratum 2 - Patients age 12-17 years at the end of the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Stratifaction 2"
              }
            }
          ]
        }
      ]
    }

    XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.