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

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: Sample CMS Hierarchical Condition Category - JSON Representation

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{
  "resourceType" : "ValueSet",
  "id" : "sample-cmshcc",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-cmshcc.html\"><code>http://terminology.hl7.org/CodeSystem/cmshcc</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td>22</td><td>Morbid Obesity</td></tr><tr><td>88</td><td>Angina Pectoris</td></tr><tr><td>112</td><td>Fibrosis of Lung and Other Chronic Lung Disorders</td></tr></table></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "cqi"
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc",
  "version" : "2.0.0-preview",
  "name" : "SampleCMSHCC",
  "title" : "Sample CMS Hierarchical Condition Category",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-05-16T08:34:40+00:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "This is a sample of the concepts that can be found in the CMS Hierarchical Condition Categories (CMS-HCC) code system version 24. The source of the codes included in this example was published at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories (CCs) that predict costs well. The condition categories (CCs) are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the Condition Categories (CCs) to capture the most costly diagnoses. Hierarchy logic is imposed on certain Condition Categories (CCs) to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
        "concept" : [
          {
            "code" : "22",
            "display" : "Morbid Obesity"
          },
          {
            "code" : "88",
            "display" : "Angina Pectoris"
          },
          {
            "code" : "112",
            "display" : "Fibrosis of Lung and Other Chronic Lung Disorders"
          }
        ]
      }
    ]
  }
}