ecqm.unions

Independent Risk Diagnosis Union

Description:

Based On: Union58

Used By:

• CMS249v1

QDM Attributes

AnkylosingSpondylitisDiagnosis

Clinical Focus: This set of values contains codes that identify patients with a diagnosis of ankylosing spondylitis.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Include all diagnosis codes associated with ankylosing spondylitis with comorbidities and associated system involvement.

Exclusion Criteria: Exclude all diagnosis codes associated with juvenile ankylosing spondylitis.

ResultValue constrained to codes in the Ankylosing Spondylitis valueset (2.16.840.1.113883.3.464.1003.113.12.1045)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

AnkylosingSpondylitisDiagnosis

0..*

CushingsSyndromeDiagnosis

Clinical Focus: This set of values contains codes that identify patients with a diagnosis of cushings syndrome.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Include all diagnosis codes for hypercortiosolism, pituitary ACTH hypersecretion, and cushings syndrome. Also Include syndrome induced by tumors, alcohol, and depression.

Exclusion Criteria: N/A

ResultValue constrained to codes in the Cushings Syndrome valueset (2.16.840.1.113883.3.464.1003.117.12.1009)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

CushingsSyndromeDiagnosis

0..*

EhlersDanlosSyndromeDiagnosis

Clinical Focus: This set of values contains codes that identify patients with a diagnosis of Ehlers Danlos Syndrome.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Include all diagnosis codes for Ehlers-Danlos Syndrome.

Exclusion Criteria: N/A

ResultValue constrained to codes in the Ehlers Danlos Syndrome valueset (2.16.840.1.113883.3.464.1003.113.12.1047)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

EhlersDanlosSyndromeDiagnosis

0..*

EndStageRenalDiseaseDiagnosis

Clinical Focus: Under Development

Data Element Scope: Under Development

Inclusion Criteria: Under Development

Exclusion Criteria: Under Development

ResultValue constrained to codes in the End Stage Renal Disease valueset (2.16.840.1.113883.3.526.3.353)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

EndStageRenalDiseaseDiagnosis

0..*

HyperparathyroidismDiagnosis

Clinical Focus: This set of values contains codes that are used to identify patients with a diagnosis of primary, secondary, tertiary, and all other types of hyperparathyroidism.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Include all diagnosis codes associated with hyperparathyroidism, with or without reference to complications and comorbidities.

Exclusion Criteria: Excludes diagnoses of autonomous thyroid function, Iatrogenic thyrotoxicosis factitia, neonatal thyrotoxicosis, and thyrotoxic crisis.

ResultValue constrained to codes in the Hyperparathyroidism valueset (2.16.840.1.113883.3.464.1003.117.12.1016)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

HyperparathyroidismDiagnosis

0..*

LupusDiagnosis

Clinical Focus: This set of values contains codes that identify patients with a diagnosis of lupus (lupus erythematosus).

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Includes diagnosis codes for systemic, discoid, and drug-induced lupus erythematosus.

Exclusion Criteria: Excludes diagnosis codes for systemic lupus erythematosus in childhood or in remission.

ResultValue constrained to codes in the Lupus valueset (2.16.840.1.113883.3.464.1003.117.12.1010)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

LupusDiagnosis

0..*

MarfansSyndromeDiagnosis

Clinical Focus: This value set identifies patients with a diagnosis of marfan's syndrome.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Includes diagnosis codes for marfan's syndome with or without cardiovascular, occular, skeletal, or epithelial manifestations.

Exclusion Criteria: N/A

ResultValue constrained to codes in the Marfan's Syndrome valueset (2.16.840.1.113883.3.464.1003.113.12.1048)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

MarfansSyndromeDiagnosis

0..*

OsteogenesisImperfectaDiagnosis

Clinical Focus: This value set identifies patients with a diagnosis of osteogenesis imperfecta.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Includes diagnosis codes for osteogenesis imperfecta disease classifications 1-4. Does include diagnoses in perinatal population.

Exclusion Criteria: Excludes diagnosis of osteoporosis with pseudoglioma.

ResultValue constrained to codes in the Osteogenesis Imperfecta valueset (2.16.840.1.113883.3.464.1003.113.12.1044)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

OsteogenesisImperfectaDiagnosis

0..*

PsoriaticArthritisDiagnosis

Clinical Focus: This value set identifies patients with a diagnosis of psoriatic arthritis.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Includes diagnosis codes for psoriatic arthritis, arthritis mutilans, psoriatic spondylitis, and other unspecified psoriatic arthropathy.

Exclusion Criteria: Excludes diagnosis codes for juvenile psoriatic arthritis and dactylitis.

ResultValue constrained to codes in the Psoriatic Arthritis valueset (2.16.840.1.113883.3.464.1003.113.12.1046)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

PsoriaticArthritisDiagnosis

0..*

Type1DiabetesDiagnosis

Clinical Focus: This set of values contains codes that identify patients with a diagnosis of type 1 diabetes mellitus and distinguishes these patients from patients with other types of diabetes mellitus, including gestational, drug-induced or type 2 diabetes mellitus.

Data Element Scope: This value set is developed for the diagnosis QDM datatype. It can potentially be used for other datatypes as well.

Inclusion Criteria: Include all diagnosis codes associated with type 1 diabetes mellitus , with or without reference to complications and comorbidities.

Exclusion Criteria: Exclude all diagnosis codes associated with gestational, drug-induced and type 2 diabetes mellitus without mention of type 1 diabetes mellitus.

ResultValue constrained to codes in the Type 1 Diabetes valueset (2.16.840.1.113883.3.464.1003.103.12.1020)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

Type1DiabetesDiagnosis

0..*