![.](tbl_spacer.png) 0 Table of Contents |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 1 Da Vinci Risk Adjustment Implementation Guide Home Page |
![.](tbl_spacer.png) ![.](tbl_vjoin-open.png) 2 Methodology |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 2.1 General Guidance |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 2.2 Report Generation |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 2.3 Report Query |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin.png) 2.4 Submit Data To Payer |
![.](tbl_spacer.png) ![.](tbl_vline.png) ![.](tbl_vjoin_end.png) 2.5 Add Remark to Condition Category |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 3 Digital Condition Category (dCC) |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 4 Profiles |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 5 Extensions |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 6 Terminology |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 7 Operation |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 8 Capability Statement |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 9 Examples |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 10 Glossary |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 11 Downloads |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 12 Change Log |
![.](tbl_spacer.png) ![.](tbl_vjoin_end-open.png) 13 Artifacts Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.1 Risk Adjustment Data Submission Client Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.2 Risk Adjustment Data Submission Server Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.3 Risk Adjustment Reporting Client Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.4 Risk Adjustment Reporting Server Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.5 Evaluate Measure |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.6 Risk Adjustment Data Exchange MeasureReport |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.7 Risk Adjustment Coding Gap Report Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.8 Risk Adjustment Coding Gap MeasureReport |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.9 Risk Adjustment Model Measure |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.10 Patient Group |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.11 Condition Category Remark |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.12 Risk Adjustment Condition Category Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.13 Risk Adjustment Clinical Data Collection Deadline |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.14 Confidence Scale |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.15 Diagnosis Code |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.16 Evidence Status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.17 Risk Adjustment Evidence Status Date |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.18 Group Reference |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.19 Hierarchical Status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.20 Payer Coding Gap Report Id |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.21 Reporting Vendor Extension |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.22 Risk Adjustment Conditioin Category Type ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.23 Coding Gap Remark |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.24 Confidence Scale Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.25 Risk Adjustment Evidence Status ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.26 Risk Adjustment Hierarchical Status ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.27 Remark Reason |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.28 Sample CMS Hierarchical Condition Category |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.29 Risk Adjustment Condition Categoryy Type CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.30 Coding Gap Remark CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.31 Risk Adjustment Evidence Status CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.32 Risk Adjustment Hierarchical Status CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.33 Remark Reason CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.34 ra-bundle01: Risk Adjustment Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.35 ra-group01: Risk Adjustment Patient Group |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.36 ra-group02: Risk Adjustment Patient Group |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.37 ra-measurereport01: Risk Adjustment Measure Report |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.38 ra-measurereport01-with-remark: Risk Adjustment Measure Report with Condition Category Remark |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.39 ra-measurereport02: Risk Adjustment Measure Report |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.40 ra-measurereport03: Risk Adjustment Measure Report for HCC V24 for Patient 02 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.41 ra-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.42 ra-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.43 ra-measurereport06: Risk Adjustment Measure Report for RxHCC V5 for Patient02 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.44 Condition01pat03: Other artificial openings of gastrointestinal tract status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.45 Condition02pat01: Diabetes mellitus due to underlying condition with other diabetic kidney complication |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.46 Condition03pat01: Chronic obstructive pulmonary disease with (acute) exacerbation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.47 Condition04pat03: Chronic obstructive pulmonary disease with (acute) exacerbation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.48 Condition05pat03: Unspecified protein-calorie malnutrition |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.49 Condition06pat03: Crohn's disease of large intestine with unspecified complicationss |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.50 Condition07pat03: Other persistent atrial fibrillation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.51 Condition08pat01: Bipolar disorder, current episode mixed, mild |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.52 Condition09pat01: Allergic bronchopulmonary aspergillosis |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.53 Condition10pat01: Long term (current) use of insulin |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.54 Condition11pat01: Acute pulmonary edema |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.55 Condition12pat01: Manic episode, unspecified |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.56 Condition15pat03: Diabetes mellitus due to underlying condition with diabetic chronic kidney diseases |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.57 Condition16pat03: Dependence on renal dialysis |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.58 Condition17pat01: Body mass index [BMI] 45.0-49.9, adult |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.59 Condition18pat01: Longstanding persistent atrial fibrillation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.60 ConditionR01pat01: Cystic fibrosis with other intestinal manifestations |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.61 Condition21pat03: Type 2 diabetes mellitus without complications |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.62 Condition22pat03: Other acute kidney failure |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.63 Condition23pat03: Chronic kidney disease, stage 5 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.64 Condition31pat02: Typical atrial flutter |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.65 Condition32pat03: Chronic pulmonary embolism |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.66 Condition33pat01: Respiratory arrest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.67 Condition35pat03: Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.68 Condition42pat03: Other artificial openings of gastrointestinal tract status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.69 Condition43pat01: Diabetes mellitus due to underlying condition with other diabetic kidney complication |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.70 Condition44pat01: Allergic bronchopulmonary aspergillosis |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.71 Documentreference01pat01: Outpatient Note |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.72 Encounter on 20210714 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.73 Encounter on 20210131 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.74 Encounter on 20210926 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.75 Encounter on 20201218 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.76 Encounter on 20200303 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.77 Encounter on 20200917 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.78 Encounter on 20190207 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.79 Encounter on 20170203 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.80 Encounter on 20210327 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.81 Encounter on 20201102 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.82 Encounter on 20200808 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.83 Encounter on 20210727 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.84 Encounter on 20210823 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.85 Encounter on 20210130 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.86 Encounter on 20210701 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.87 Encounter on 20210806 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.88 Encounter on 20210212 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.89 Encounter on 20200210 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.90 Encounter on 20190210 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.91 Encounter on 20170118 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.92 Encounter on 20180721 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.93 Encounter on 2021-10-15 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.94 Observation: Trypsin [Mass/volume] in Serum or Plasma result from 20190617 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.95 Observation: Creatinine Result from 20210728 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.96 Observation: PHQ9 from 20190823 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.97 Trypsin [Mass/volume] in Serum or Plasma from 20170617 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.98 Laboratory01: XYZ Laboratory |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.99 Vendor01: Best RA Vendor |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.100 Organization01: ABC Payer |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.101 Organization: Community Urgent Care |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.102 Organization: GHH Outpatient Clinic |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.103 Organization: Community HealthCenter |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.104 Organization: Risk Adjustment Author |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.105 Risk Adjustement Measure Report Patch |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.106 Risk Adjustement Measure Report Patch With Multiple Values |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.107 Patient01: Eve Everywoman |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.108 Patient02: Adam Everyman |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.109 Patient03: Nelda Nuclear |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.110 Practitioner: Harold Hippocrates |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.111 Practitioner: Patrick Pump |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.112 Practitioner: Otto Osler |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.113 ra-datax-measurereport01: Risk Adjustment Data Exchange Measure Report |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.114 Submit Data for Risk Adjustement Data Exchange MeasureReport |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.115 Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC) |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.116 Risk Adjustment Model Version 21 - CMS Hierarchical Category Condition (CMS-HCC) |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin_end.png) 13.117 Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC) |