ra-bundle01: Risk Adjustment Bundle - Da Vinci Risk Adjustment Implementation Guide v2.0.0

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 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 Bundle: ra-bundle01: Risk Adjustment Bundle

Generated Narrative: Bundle ra-bundle01

Bundle ra-bundle01 of type collection

Entry 1 - fullUrl = http://example.org/fhir/MeasureReport/ra-measurereport01

Resource MeasureReport:

Generated Narrative: MeasureReport ra-measurereport01

Measure Report Category: Risk Adjustment
Risk Adjustment Clinical Data Collection Deadline: 2022-03-31
status: Complete
type: Individual
measure: Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
date: 2021-10-18
reporter: Organization ABC Payer
period: 2021-01-01 --> 2021-09-30
group
id
group-001
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Closed Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-04-01
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 18: Diabetes with Chronic Complications
group
id
group-002
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Pending Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-09-29
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 111: Chronic Obstructive Pulmonary Disease
group
id
group-003
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Open Condition Category Gap
Risk Adjustment Evidence Status Date: 2020-07-15
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 59: Major Depressive, Bipolar, and Paranoid Disorders
group
id
group-004
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Closed Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-04-27
Hierarchical Status: Hierarchies applied and Condition Category is superseded
code: HCC 112: Fibrosis of lung and other chronic lung disorders
group
id
group-005
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Pending Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-09-27
Hierarchical Status: Hierarchies applied and Condition Category is superseded
code: HCC 19: Diabetes without Complications
group
id
group-006
Risk Adjustment Condition Category Type: Historic Condition Category Gap
Evidence Status: Open Condition Category Gap
Risk Adjustment Evidence Status Date: 2020-12-15
Hierarchical Status: Hierarchies applied and Condition Category is superseded
code: HCC 84: Cardio-Respiratory Failure and Shock
group
id
group-007
Risk Adjustment Condition Category Type: Suspected Condition Category Gap
Evidence Status: Closed Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-03-15
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 22: Morbid Obesity
group
id
group-008
Risk Adjustment Condition Category Type: Suspected Condition Category Gap
Evidence Status: Pending Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-09-27
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 96: Specified Heart Arrhythmias
group
id
group-009
Risk Adjustment Condition Category Type: Suspected Condition Category Gap
Evidence Status: Open Condition Category Gap
Risk Adjustment Evidence Status Date: 2020-07-15
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 110: Cystic Fibrosis
group
id
group-010
Risk Adjustment Condition Category Type: Net-New Condition Category
Evidence Status: Pending Condition Category Gap
Risk Adjustment Evidence Status Date: 2021-09-28
Hierarchical Status: Hierarchies applied and Condition Category is not superseded
code: HCC 110: Cystic Fibrosis
evaluatedResource:
Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication
Condition Chronic obstructive pulmonary disease with (acute) exacerbation
Condition Bipolar disorder, current episode mixed, mild
Condition Allergic bronchopulmonary aspergillosis
Condition Long term (current) use of insulin
Condition Acute pulmonary edema
Condition Body mass index [BMI] 45.0-49.9, adult
Condition Longstanding persistent atrial fibrillation
Condition Respiratory arrest
Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication
Condition Allergic bronchopulmonary aspergillosis
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-01-31 --> 2021-01-31
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-09-26 --> 2021-09-26
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-02-03 --> 2017-02-03
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-03-27 --> 2021-03-27
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2020-11-02 --> 2020-11-02
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2019-02-10 --> 2019-02-10
Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-01-18 --> 2017-01-18
Observation Trypsin [Mass/volume] in Serum or Plasma

Entry 2 - fullUrl = http://example.org/fhir/Condition/ra-condition33pat01

Resource Condition:

Generated Narrative: Condition ra-condition33pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: R09.2: Respiratory arrest
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-09-26

Entry 3 - fullUrl = http://example.org/fhir/Patient/ra-patient01

Resource Patient:

Eve EVERYWOMAN
Identifier 12345
Address 2222 Home Street
Ann Arbor MI USA
Date of birth 16 January 1975

Entry 4 - fullUrl = http://example.org/fhir/Condition/ra-condition10pat01

Resource Condition:

Generated Narrative: Condition ra-condition10pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: J44.1: Chronic obstructive pulmonary disease with (acute) exacerbation
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-09-26

Entry 5 - fullUrl = http://example.org/fhir/Encounter/ra-encounter03pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter03pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Chronic obstructive pulmonary disease with (acute) exacerbation)
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Long term (current) use of insulin)
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Longstanding persistent atrial fibrillation)
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Respiratory arrest)

Entry 6 - fullUrl = http://example.org/fhir/Condition/ra-condition09pat01

Resource Condition:

Generated Narrative: Condition ra-condition09pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: B44.81: Allergic bronchopulmonary aspergillosis
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-03-27

Entry 7 - fullUrl = http://example.org/fhir/Condition/ra-condition02pat01

Resource Condition:

Generated Narrative: Condition ra-condition02pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: E08.29: Diabetes mellitus due to underlying condition with other diabetic kidney complication
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-01-31

Entry 8 - fullUrl = http://example.org/fhir/Encounter/ra-encounter11pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter11pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Condition Acute pulmonary edema)

Entry 9 - fullUrl = http://example.org/fhir/Observation/ra-obs21pat01

Resource Observation:

Generated Narrative: Observation ra-obs21pat01

status: Final
category: Laboratory
code: Trypsin [Mass/volume] in Serum or Plasma
subject: Eve Everywoman
effective: 2019-06-17
performer: XYZ Laboratory
value: 770 ng/mL
ReferenceRanges
- Low High Type
* 169 ng/mL (Details: UCUM codeng/mL = 'ng/mL') 773 ng/mL (Details: UCUM codemg/dL = 'mg/dL') Normal Range

Entry 10 - fullUrl = http://example.org/fhir/Condition/ra-condition18pat01

Resource Condition:

Generated Narrative: Condition ra-condition18pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: I48.11: Longstanding persistent atrial fibrillation
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-09-26

Entry 11 - fullUrl = http://example.org/fhir/Encounter/ra-encounter08pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter08pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Condition Bipolar disorder, current episode mixed, mild)

Entry 12 - fullUrl = http://example.org/fhir/Condition/ra-condition44pat01

Resource Condition:

Generated Narrative: Condition ra-condition44pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: B44.81: Allergic bronchopulmonary aspergillosis
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2017-01-18

Entry 13 - fullUrl = http://example.org/fhir/Encounter/ra-encounter02pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter02pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication)
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Body mass index [BMI] 45.0-49.9, adult)

Entry 14 - fullUrl = http://example.org/fhir/Encounter/ra-encounter44pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter44pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Condition Allergic bronchopulmonary aspergillosis)

Entry 15 - fullUrl = http://example.org/fhir/Condition/ra-condition08pat01

Resource Condition:

Generated Narrative: Condition ra-condition08pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: Bipolar disorder, current episode mixed, mild
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2017-02-03

Entry 16 - fullUrl = http://example.org/fhir/Condition/ra-condition43pat01

Resource Condition:

Generated Narrative: Condition ra-condition43pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: E08.29: Diabetes mellitus due to underlying condition with other diabetic kidney complication
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2019-02-10

Entry 17 - fullUrl = http://example.org/fhir/Condition/ra-condition03pat01

Resource Condition:

Generated Narrative: Condition ra-condition03pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: J44.1: Chronic obstructive pulmonary disease with (acute) exacerbation
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-09-26

Entry 18 - fullUrl = http://example.org/fhir/Condition/ra-condition11pat01

Resource Condition:

Generated Narrative: Condition ra-condition11pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: J81.0: Acute pulmonary edema
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2020-11-02

Entry 19 - fullUrl = http://example.org/fhir/Encounter/ra-encounter43pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter43pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication)

Entry 20 - fullUrl = http://example.org/fhir/Encounter/ra-encounter09pat01

Resource Encounter:

Generated Narrative: Encounter ra-encounter09pat01

status: completed
class: ambulatory
type: Office Visit, High Complexity
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
serviceProvider: Organization Community Urgent Care
participant
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Condition Allergic bronchopulmonary aspergillosis)

Entry 21 - fullUrl = http://example.org/fhir/Condition/ra-condition17pat01

Resource Condition:

Generated Narrative: Condition ra-condition17pat01

clinicalStatus: Active
verificationStatus: Confirmed
category: Problem
code: Z68.42: Body mass index [BMI] 45.0-49.9, adult
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
onset: 2021-01-31

Identifier	12345
Address	2222 Home Street Ann Arbor MI USA
Date of birth	16 January 1975