Da Vinci Risk Adjustment Implementation Guide
2.0.0 - STU2
Da Vinci Risk Adjustment Implementation Guide
2.0.0 - STU2
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
| Page standards status: Informative |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport ra-measurereport05</b></p><a name=\"ra-measurereport05\"> </a><a name=\"hcra-measurereport05\"> </a><a name=\"ra-measurereport05-en-US\"> </a><p><b>Measure Report Category</b>: <span title=\"Codes:{http://hl7.org/fhir/CodeSystem/measurereport-category ra}\">Risk Adjustment</span></p><p><b>Risk Adjustment Clinical Data Collection Deadline</b>: 2022-03-31</p><p><b>status</b>: Complete</p><p><b>type</b>: Individual</p><p><b>measure</b>: <a href=\"Measure-RAModelExample03.html\">Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC)</a></p><p><b>subject</b>: <a href=\"Patient-ra-patient03.html\">Nelda Nuclear (official) Female, DoB: 1965-07-26 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2021-10-18</p><p><b>reporter</b>: <a href=\"Organization-ra-payer01.html\">Organization ABC Payer</a></p><p><b>period</b>: 2021-01-01 --> 2021-09-30</p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-001</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}\">Pending Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 226}\">CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-002</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 31}\">CMS-RxHCC 31: Diabetes without Complication</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-003</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 30}\">CMS-RxHCC 30: Diabetes with Complications</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-004</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 261}\">CMS-RxHCC 261: Dialysis Status</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-005</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}\">Open Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 262}\">CMS-RxHCC 262: Chronic Kidney Disease Stage 5</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-006</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type net-new}\">Net-New Condition Category</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status not-applied}\">Hierarchies not applied</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmsrxhcc 216}\">CMS-RxHCC 216: Peripheral Vascular Disease</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Condition-ra-condition04pat03.html\">Condition Chronic obstructive pulmonary disease with (acute) exacerbation</a></li><li><a href=\"Condition-ra-condition21pat03.html\">Condition Type 2 diabetes mellitus without complications</a></li><li><a href=\"Condition-ra-condition15pat03.html\">Condition Diabetes mellitus due to underlying condition with diabetic chronic kidney disease</a></li><li><a href=\"Condition-ra-condition16pat03.html\">Condition Dependence on renal dialysis</a></li><li><a href=\"Condition-ra-condition35pat03.html\">Condition Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene</a></li><li><a href=\"Encounter-ra-encounter04pat03.html\">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 = 2020-12-18 --> 2020-12-18</a></li><li><a href=\"Encounter-ra-encounter21pat03.html\">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 = 2021-01-30 --> 2021-01-30</a></li><li><a href=\"Encounter-ra-encounter15pat03.html\">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 = 2021-08-08 --> 2021-08-08</a></li><li><a href=\"Encounter-ra-encounter16pat03.html\">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 = 2021-07-27 --> 2021-07-27</a></li><li><a href=\"Encounter-ra-encounter35pat03.html\">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 = 2021-02-12 --> 2021-02-12</a></li><li><a href=\"Observation-ra-obs01pat03.html\">Observation Creat SerPl-mCnc</a></li></ul></div>"
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"text" : "CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma"
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"code" : "30",
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"text" : "CMS-RxHCC 30: Diabetes with Complications"
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{
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"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/cmsrxhcc",
"version" : "5",
"code" : "261",
"display" : "Dialysis Status"
}
],
"text" : "CMS-RxHCC 261: Dialysis Status"
}
},
{
"id" : "group-005",
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"coding" : [
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"system" : "http://terminology.hl7.org/CodeSystem/cmsrxhcc",
"version" : "5",
"code" : "262",
"display" : "Chronic Kidney Disease Stage 5"
}
],
"text" : "CMS-RxHCC 262: Chronic Kidney Disease Stage 5"
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"version" : "5",
"code" : "216",
"display" : "Peripheral Vascular Disease"
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"url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
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"reference" : "Condition/ra-condition04pat03"
},
{
🔗 "extension" : [
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"valueString" : "group-002"
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],
"reference" : "Condition/ra-condition21pat03"
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🔗 "extension" : [
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"reference" : "Condition/ra-condition15pat03"
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🔗 "extension" : [
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"reference" : "Condition/ra-condition16pat03"
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🔗 "extension" : [
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"reference" : "Condition/ra-condition35pat03"
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🔗 "extension" : [
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],
"reference" : "Encounter/ra-encounter04pat03"
},
{
🔗 "extension" : [
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🔗 "extension" : [
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],
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},
{
🔗 "extension" : [
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],
"reference" : "Encounter/ra-encounter35pat03"
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🔗 "extension" : [
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"valueString" : "group-005"
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],
"reference" : "Observation/ra-obs01pat03"
}
]
}
IG © 2021+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.davinci-ra#2.0.0 based on FHIR 4.0.1. Generated 2024-12-10
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