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-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03

Generated Narrative: MeasureReport

ResourceMeasureReport "ra-measurereport04"

Profile: Risk Adjustment Coding Gap MeasureReport

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

status: complete

type: individual

measure: Risk Adjustment Model Version 21 - CMS Hierarchical Category Condition (CMS-HCC)

subject: Patient/ra-patient03 " NUCLEAR"

date: 2021-10-18

reporter: Organization/ra-payer01 "ABC Payer"

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

group

id

group-001

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 188: Artificial Openings for Feeding or Elimination (CMS Hierarchical Condition Categories[21]#188 "Artificial Openings for Feeding or Elimination")

group

id

group-002

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 111: Chronic Obstructive Pulmonary Disease (CMS Hierarchical Condition Categories[21]#111 "Chronic Obstructive Pulmonary Disease")

group

id

group-003

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 21: Protein-Calorie Malnutrition (CMS Hierarchical Condition Categories[21]#21 "Protein-Calorie Malnutrition")

group

id

group-004

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 35: Inflammatory Bowel Disease (CMS Hierarchical Condition Categories[21]#35 "Inflammatory Bowel Disease")

group

id

group-005

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 96: Specified Heart Arrhythmia (CMS Hierarchical Condition Categories[21]#96 "Specified Heart Arrhythmias")

group

id

group-006

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 18: Diabetes with Chronic Complications (CMS Hierarchical Condition Categories[21]#18 "Diabetes with Chronic Complications")

group

id

group-007

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 134: Dialysis Status (CMS Hierarchical Condition Categories[21]#134 "Dialysis Status")

group

id

group-008

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 58: Major Depressive, Bipolar, and Paranoid Disorders (CMS Hierarchical Condition Categories[21]#58 "Major Depressive, Bipolar, and Paranoid Disorders")

group

id

group-009

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

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

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: CMS-HCC 19: Diabetes without Complication (CMS Hierarchical Condition Categories[21]#19 "Diabetes without Complication")

group

id

group-010

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

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

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: CMS-HCC 135: Acute Renal Failure (CMS Hierarchical Condition Categories[21]#135 "Acute Renal Failure")

group

id

group-011

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

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

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: CMS-HCC 136: Chronic Kidney Disease, Stage 5 (CMS Hierarchical Condition Categories[21]#136 "Chronic Kidney Disease, Stage 5")

group

id

group-012

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

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

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: CMS-HCC 107: Vascular Disease with Complications (CMS Hierarchical Condition Categories[21]#107 "Vascular Disease with Complications")

group

id

group-013

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

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

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: CMS-HCC 108: Vascular Disease (CMS Hierarchical Condition Categories[21]#108 "Vascular Disease")

evaluatedResource: