CDC MME CQL Calculator
3.0.0 - release
CDC MME CQL Calculator
3.0.0 - release
This page is part of the CDC Opioid MME Calculator (v3.0.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:CodeSystem;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "CDCMMEClinicalConversionFactors"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-shareablecodesystem";
fhir:index 0;
fhir:link <http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-shareablecodesystem> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Properties</b></p><table class=\"grid\"><tr><td><b>Code</b></td><td><b>Type</b></td><td><b>Description</b></td></tr><tr><td>conversion-factor</td><td>decimal</td><td>Defines the conversion factor for a specific ingredient, when the conversion factor is the same for all dose forms and dose amounts for the ingredient. The value of this property will be the decimal representation of the conversion factor.</td></tr><tr><td>dose-form-conversion-factor</td><td>string</td><td>Defines the conversion factor for an ingredient when the conversion factor varies by the dose form of the medication. The value of this property will be a string of the form <dose-form-code>:<conversion-factor>[@<doses-per-day>], e.g. 970789:130, where '970789' is the RxNorm dose form code, and '130' is the decimal representation of the conversion factor. An example of a per-day conversion factor is fentanyl, 316987:7200@0.33333333, where 316987 is RxNorm dose form code, 7200 is the conversion factor, and 0.33333333 is the dosesPerDay, expressed as a decimal with a maximum of 8 digits after the decimal.</td></tr><tr><td>dose-range-conversion-factor</td><td>string</td><td>Defines the conversion factor for an ingredient when the conversion factor varies by the overall dose of the medication. The value of this property will be a string of the form <low-value>-<high-value>:<conversion-factor>, e.g. 1-20:4. Note that the low-value or high-value may be a wildcard '*' to indicate the range continues (e.g. '61-*:12' indicates the range is 61 or greater).</td></tr></table><p/><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>conversion-factor</b></td><td><b>dose-form-conversion-factor</b></td><td><b>dose-range-conversion-factor</b></td></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=2670\">2670</a><a name=\"CDCMMEClinicalConversionFactors-2670\"> </a></td><td>Codeine</td><td>0.15</td><td/><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=4337\">4337</a><a name=\"CDCMMEClinicalConversionFactors-4337\"> </a></td><td>Fentanyl</td><td/><td>316987:7200@0.33333333</td><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=5489\">5489</a><a name=\"CDCMMEClinicalConversionFactors-5489\"> </a></td><td>Hydrocodone</td><td>1</td><td/><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=3423\">3423</a><a name=\"CDCMMEClinicalConversionFactors-3423\"> </a></td><td>Hydromorphone</td><td>4</td><td/><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=6813\">6813</a><a name=\"CDCMMEClinicalConversionFactors-6813\"> </a></td><td>Methadone</td><td/><td/><td>1-20:4, 21-40:8, 41-60:10, 61-*:12</td></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=7052\">7052</a><a name=\"CDCMMEClinicalConversionFactors-7052\"> </a></td><td>Morphine</td><td>1</td><td/><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=7804\">7804</a><a name=\"CDCMMEClinicalConversionFactors-7804\"> </a></td><td>Oxycodone</td><td>1.5</td><td/><td/></tr><tr><td><a style=\"white-space:nowrap\" href=\"https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=7814\">7814</a><a name=\"CDCMMEClinicalConversionFactors-7814\"> </a></td><td>Oxymorphone</td><td>3</td><td/><td/></tr></table></div>"
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fhir:DomainResource.extension [
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fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability" ];
fhir:Extension.valueCode [ fhir:value "shareable" ]
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fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability" ];
fhir:Extension.valueCode [ fhir:value "publishable" ]
], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel" ];
fhir:Extension.valueCode [ fhir:value "structured" ]
], [
fhir:index 3;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-sourceReference" ];
fhir:Extension.valueUri [ fhir:value "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf" ]
], [
fhir:index 4;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-author" ];
fhir:Extension.valueString [ fhir:value "Floyd Eisenberg, MD, MPH" ]
], [
fhir:index 5;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-author" ];
fhir:Extension.valueString [ fhir:value "Kensaku Kawamoto, MD, PhD, MHS" ]
], [
fhir:index 6;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-author" ];
fhir:Extension.valueString [ fhir:value "Robert McClure, MD" ]
], [
fhir:index 7;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-author" ];
fhir:Extension.valueString [ fhir:value "Bryn Rhodes" ]
], [
fhir:index 8;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-topic" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "Opioid Prescribing" ] ]
], [
fhir:index 9;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-topic" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "Morphine Milligram Equivalent (MME)" ] ]
], [
fhir:index 10;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/codesystem-warning" ];
fhir:Extension.valueMarkdown [ fhir:value "NOTE: Do not use the calculated dose in MMEs to determine dosage for converting one opioid to another—the new opioid should be lower to avoid unintentional overdose caused by incomplete cross-tolerance and individual differences in opioid pharmacokinetics. Consult the medication label." ]
], [
fhir:index 11;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-relatedArtifact" ];
fhir:Extension.valueRelatedArtifact [
fhir:RelatedArtifact.type [ fhir:value "citation" ];
fhir:RelatedArtifact.label [ fhir:value "RxNORM" ];
fhir:RelatedArtifact.display [ fhir:value "This product uses publicly available data 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 product and does not endorse or recommend this or any other product." ];
fhir:RelatedArtifact.citation [ fhir:value "Nelson SJ, Zeng K, Kilbourne J, Powell T, Moore R. Normalized names for clinical drugs: RxNorm at 6 years.<br/>J Am Med Inform Assoc. 2011 Jul-Aug;18(4)441-8. doi: 10.1136/amiajnl-2011-000116.<br/>Epub 2011 Apr 21. PubMed PMID: 21515544; PubMed Central PMCID: PMC3128404.<br/>[Full Text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128404/)" ];
fhir:RelatedArtifact.url [ fhir:value "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128404/" ] ]
], [
fhir:index 12;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-relatedArtifact" ];
fhir:Extension.valueRelatedArtifact [
fhir:RelatedArtifact.type [ fhir:value "citation" ];
fhir:RelatedArtifact.label [ fhir:value "UCUM" ];
fhir:RelatedArtifact.display [ fhir:value "This product includes all or a portion of the UCUM table, UCUM codes, and UCUM definitions or is derived from it, subject to a license from Regenstrief Institute, Inc. and The UCUM Organization. Your use of the UCUM table, UCUM codes, UCUM definitions also is subject to this license, a copy of which is available at http://unitsofmeasure.org<br/> The current complete UCUM table, UCUM Specification are available for download at http://unitsofmeasure.org<br/>The UCUM table and UCUM codes are copyright © 1995-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved." ];
fhir:RelatedArtifact.citation [ fhir:value "Schadow G, McDonald CJ. The Unified Code for Units of Measure. Regenstrief Institute, Inc. and the UCUM Organization, 2017. Version 2.1, Revision 442. http://unitsofmeasure.org" ];
fhir:RelatedArtifact.url [ fhir:value "http://unitsofmeasure.org" ] ]
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fhir:index 13;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-relatedArtifact" ];
fhir:Extension.valueRelatedArtifact [
fhir:RelatedArtifact.type [ fhir:value "citation" ];
fhir:RelatedArtifact.label [ fhir:value "CDC Opioid Prescribing Guideline" ];
fhir:RelatedArtifact.display [ fhir:value "Centers For Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain — United States, 2016" ];
fhir:RelatedArtifact.citation [ fhir:value "Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1" ];
fhir:RelatedArtifact.url [ fhir:value "http://dx.doi.org/10.15585/mmwr.rr6501e1" ] ]
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fhir:index 14;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-relatedArtifact" ];
fhir:Extension.valueRelatedArtifact [
fhir:RelatedArtifact.type [ fhir:value "citation" ];
fhir:RelatedArtifact.label [ fhir:value "Calculating total daily dose of opioids for safer dosage" ];
fhir:RelatedArtifact.display [ fhir:value "National Center for Injury Prevention and Control. Calculating total daily dose of opioids for safer dosage." ];
fhir:RelatedArtifact.citation [ fhir:value "National Center for Injury Prevention and Control. Calculating total daily dose of opioids for safer dosage.<br/>Atlanta, GA: Centers for Disease Control and Prevention; https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf, accessed November 19th, 2020" ];
fhir:RelatedArtifact.url [ fhir:value "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf" ] ]
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fhir:index 15;
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fhir:Extension.valueRelatedArtifact [
fhir:RelatedArtifact.type [ fhir:value "documentation" ];
fhir:RelatedArtifact.label [ fhir:value "Conversion Factors" ];
fhir:RelatedArtifact.display [ fhir:value "Conversion Factors" ];
fhir:RelatedArtifact.url [ fhir:value "http://fhir.org/guides/cdc/opioid-mme-r4/conversion-factors.html" ] ]
];
fhir:CodeSystem.url [ fhir:value "http://fhir.org/guides/cdc/opioid-mme-r4/CodeSystem/CDCMMEClinicalConversionFactors"];
fhir:CodeSystem.version [ fhir:value "3.0.0"];
fhir:CodeSystem.name [ fhir:value "CDCMMEClinicalConversionFactors"];
fhir:CodeSystem.title [ fhir:value "CDC MME Clinical Conversion Factors"];
fhir:CodeSystem.status [ fhir:value "active"];
fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean];
fhir:CodeSystem.date [ fhir:value "2021-11-25T15:15:41+11:00"^^xsd:dateTime];
fhir:CodeSystem.publisher [ fhir:value "Alphora"];
fhir:CodeSystem.contact [
fhir:index 0;
fhir:ContactDetail.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "url" ];
fhir:ContactPoint.value [ fhir:value "http://alphora.com" ] ]
];
fhir:CodeSystem.description [ fhir:value "This Code System Supplement defines clinical conversion factors for calculating Morphine Milligram Equivalence (MME), as described in the CDC Opioid Prescribing Guideline. The supplement defines conversions factors for ingredients in one of 3 ways: 1, as a direct conversion factor for the ingredient, 2, as a dose-form-specific conversion factor for the ingredient, and 3, as a dose-quantity-ranged conversion factor for the ingredient. See the descriptions for each property for information on how the values are represented for the different conversion factors. For a given ingredient, only one of 'dose-form' or 'dose-range' will be present, with or without an ingredient-specific conversion factor. The properties together will enable a unique conversion factor to be determined if the input is within the expected range. If the input is outside the expected range, and there is no ingredient-specific conversion-factor specified, implementations should indicate a conversion factor could not be determined from the supplied information. All conversion factors supplied in this supplement are in 'mg/d'."];
fhir:CodeSystem.useContext [
fhir:index 0;
fhir:UsageContext.code [
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
fhir:Coding.code [ fhir:value "focus" ];
fhir:Coding.display [ fhir:value "Clinical Focus" ] ];
fhir:UsageContext.valueCodeableConcept [
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fhir:index 0;
a sct:182888003;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "182888003" ];
fhir:Coding.display [ fhir:value "Medication requested (situation)" ] ] ]
], [
fhir:index 1;
fhir:UsageContext.code [
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
fhir:Coding.code [ fhir:value "focus" ];
fhir:Coding.display [ fhir:value "Clinical Focus" ] ];
fhir:UsageContext.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:82423001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "82423001" ];
fhir:Coding.display [ fhir:value "Chronic pain (finding)" ] ] ]
], [
fhir:index 2;
fhir:UsageContext.code [
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
fhir:Coding.code [ fhir:value "task" ];
fhir:Coding.display [ fhir:value "Workflow Task" ] ];
fhir:UsageContext.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://fhir.org/guides/cdc/opioid-mme-r4/CodeSystem/CDCMMEUsageContextCodes" ];
fhir:Coding.code [ fhir:value "mme-calculation" ];
fhir:Coding.display [ fhir:value "MME Calculation" ] ] ]
];
fhir:CodeSystem.jurisdiction [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ];
fhir:Coding.code [ fhir:value "840" ] ]
];
fhir:CodeSystem.copyright [ fhir:value "Copyright 2019+ Centers for Disease Control and Prevention (CDC)"];
fhir:CodeSystem.content [ fhir:value "supplement"];
fhir:CodeSystem.supplements [
fhir:value "http://www.nlm.nih.gov/research/umls/rxnorm";
fhir:link <http://www.nlm.nih.gov/research/umls/rxnorm>
];
fhir:CodeSystem.property [
fhir:index 0;
fhir:CodeSystem.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.property.description [ fhir:value "Defines the conversion factor for a specific ingredient, when the conversion factor is the same for all dose forms and dose amounts for the ingredient. The value of this property will be the decimal representation of the conversion factor." ];
fhir:CodeSystem.property.type [ fhir:value "decimal" ]
], [
fhir:index 1;
fhir:CodeSystem.property.code [ fhir:value "dose-form-conversion-factor" ];
fhir:CodeSystem.property.description [ fhir:value "Defines the conversion factor for an ingredient when the conversion factor varies by the dose form of the medication. The value of this property will be a string of the form <dose-form-code>:<conversion-factor>[@<doses-per-day>], e.g. 970789:130, where '970789' is the RxNorm dose form code, and '130' is the decimal representation of the conversion factor. An example of a per-day conversion factor is fentanyl, 316987:7200@0.33333333, where 316987 is RxNorm dose form code, 7200 is the conversion factor, and 0.33333333 is the dosesPerDay, expressed as a decimal with a maximum of 8 digits after the decimal." ];
fhir:CodeSystem.property.type [ fhir:value "string" ]
], [
fhir:index 2;
fhir:CodeSystem.property.code [ fhir:value "dose-range-conversion-factor" ];
fhir:CodeSystem.property.description [ fhir:value "Defines the conversion factor for an ingredient when the conversion factor varies by the overall dose of the medication. The value of this property will be a string of the form <low-value>-<high-value>:<conversion-factor>, e.g. 1-20:4. Note that the low-value or high-value may be a wildcard '*' to indicate the range continues (e.g. '61-*:12' indicates the range is 61 or greater)." ];
fhir:CodeSystem.property.type [ fhir:value "string" ]
];
fhir:CodeSystem.concept [
fhir:index 0;
fhir:CodeSystem.concept.code [ fhir:value "2670" ];
fhir:CodeSystem.concept.display [ fhir:value "Codeine" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "0.15"^^xsd:decimal ] ]
], [
fhir:index 1;
fhir:CodeSystem.concept.code [ fhir:value "4337" ];
fhir:CodeSystem.concept.display [ fhir:value "Fentanyl" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "dose-form-conversion-factor" ];
fhir:CodeSystem.concept.property.valueString [ fhir:value "316987:7200@0.33333333" ] ]
], [
fhir:index 2;
fhir:CodeSystem.concept.code [ fhir:value "5489" ];
fhir:CodeSystem.concept.display [ fhir:value "Hydrocodone" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "1"^^xsd:decimal ] ]
], [
fhir:index 3;
fhir:CodeSystem.concept.code [ fhir:value "3423" ];
fhir:CodeSystem.concept.display [ fhir:value "Hydromorphone" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "4"^^xsd:decimal ] ]
], [
fhir:index 4;
fhir:CodeSystem.concept.code [ fhir:value "6813" ];
fhir:CodeSystem.concept.display [ fhir:value "Methadone" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "dose-range-conversion-factor" ];
fhir:CodeSystem.concept.property.valueString [ fhir:value "1-20:4" ] ], [
fhir:index 1;
fhir:CodeSystem.concept.property.code [ fhir:value "dose-range-conversion-factor" ];
fhir:CodeSystem.concept.property.valueString [ fhir:value "21-40:8" ] ], [
fhir:index 2;
fhir:CodeSystem.concept.property.code [ fhir:value "dose-range-conversion-factor" ];
fhir:CodeSystem.concept.property.valueString [ fhir:value "41-60:10" ] ], [
fhir:index 3;
fhir:CodeSystem.concept.property.code [ fhir:value "dose-range-conversion-factor" ];
fhir:CodeSystem.concept.property.valueString [ fhir:value "61-*:12" ] ]
], [
fhir:index 5;
fhir:CodeSystem.concept.code [ fhir:value "7052" ];
fhir:CodeSystem.concept.display [ fhir:value "Morphine" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "1"^^xsd:decimal ] ]
], [
fhir:index 6;
fhir:CodeSystem.concept.code [ fhir:value "7804" ];
fhir:CodeSystem.concept.display [ fhir:value "Oxycodone" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "1.5"^^xsd:decimal ] ]
], [
fhir:index 7;
fhir:CodeSystem.concept.code [ fhir:value "7814" ];
fhir:CodeSystem.concept.display [ fhir:value "Oxymorphone" ];
fhir:CodeSystem.concept.property [
fhir:index 0;
fhir:CodeSystem.concept.property.code [ fhir:value "conversion-factor" ];
fhir:CodeSystem.concept.property.valueDecimal [ fhir:value "3"^^xsd:decimal ] ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2019+ Alphora. Package fhir.cdc.opioid-mme-r4#3.0.0 based on FHIR 4.0.1. Generated 2021-11-25
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