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-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03

Generated Narrative: MeasureReport

ResourceMeasureReport "ra-measurereport05"

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

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")

group

id

group-002

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

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

group

id

group-003

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

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

group

id

group-004

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

code: CMS-RxHCC 261: Dialysis Status (CMS Prescription Drug Hierarchical Condition Categories[5]#261 "Dialysis Status")

group

id

group-005

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

code: CMS-RxHCC 262: Chronic Kidney Disease Stage 5 (CMS Prescription Drug Hierarchical Condition Categories[5]#262 "Chronic Kidney Disease Stage 5")

group

id

group-006

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

code: CMS-RxHCC 216: Peripheral Vascular Disease (CMS Prescription Drug Hierarchical Condition Categories[5]#216 "Peripheral Vascular Disease")

evaluatedResource: