Da Vinci Risk Adjustment Implementation Guide
2.0.0-preview - STU2 United States of America flag

Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

Example MeasureReport: ra-measurereport02: Risk Adjustment Measure Report

Generated Narrative: MeasureReport

Resource MeasureReport "ra-measurereport02"

Profile: Risk Adjustment Coding Gap MeasureReport

Risk Adjustment Clinical Data Collection Deadline: 2022-03-31

status: complete

type: individual

measure: Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC)

subject: Patient/ra-patient01 " EVERYWOMAN"

date: 2021-10-18

reporter: Organization/ra-payer01 "ABC Payer"

period: 2021-01-01 --> 2021-09-30

group

id

group-001

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Risk Adjustment Evidence Status Date: 2021-04-01

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 227: Pulmonary Fibrosis and Other Chronic Lung Disorders (CMS Prescription Drug Hierarchical Condition Categories[5]#227 "Pulmonary Fibrosis and Other Chronic Lung Disorders")

group

id

group-002

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Open Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#open-gap)

Risk Adjustment Evidence Status Date: 2020-07-01

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 131: Bipolar Disorders (CMS Prescription Drug Hierarchical Condition Categories[5]#131 "Bipolar Disorders")

group

id

group-003

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Risk Adjustment Evidence Status Date: 2021-02-15

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 30: Diabetes with Chronic Complications (CMS Prescription Drug Hierarchical Condition Categories[5]#30 "Diabetes with Chronic Complications")

group

id

group-004

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Risk Adjustment Evidence Status Date: 2021-04-01

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 43: Morbid Obesity (CMS Prescription Drug Hierarchical Condition Categories[5]#43 "Morbid Obesity")

group

id

group-005

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-29

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 31: Diabetes without Complications (CMS Prescription Drug Hierarchical Condition Categories[5]#31 "Diabetes without Complications")

group

id

group-006

Risk Adjustment Suspect Type: Net-New Condition Category (Risk Adjustment Suspect Type CodeSystem#net-new)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-29

Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

code: CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma (CMS Prescription Drug Hierarchical Condition Categories[5]#226 "Chronic Obstructive Pulmonary Disease and Asthma")

evaluatedResource: