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

CodeSystem: Risk Adjustment Suspect Type CodeSystem

Official URL: http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type Version: 2.0.0-preview
Active as of 2024-04-18 Computable Name: RiskAdjustmentSuspectType

Copyright/Legal: Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License

Code sytstem that indicates whether it is a suspected Condition Category (CC) gap, a historic Condition Category (CC) gap, or a net-new Condition Category (CC). Historic, suspected, and net-new are mutually exclusive.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type defines the following codes:

CodeDisplayDefinition
historic Historic Condition Category Gap Historic Condition Category (CC) Gap. Historic Condition Category (CC) is based on data from a prior clinical evaluation period.
suspected Suspected Condition Category Gap Suspected Condition Category (CC) Gap. A member never has Condition Category (CC) before, but when a Server runs a suspecting algorithm, suspected Condition Categories (CCs) are identified for the member.
net-new Net-New Condition Category Net-New Condition Category (CC). New Condition Category (CC), not from suspected process or historic. A Net-New Condition Category (CC) is documented for the first time during the clinical evaluation period for the risk adjustment model. Any Condition Categories (CCs) that are net new must be either closed-gap or pending, and can not be open-gap.