Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1 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 2.1.0 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

Extension: Condition Category Remark Extension

Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark Version: 2.1.0
Standards status: Trial-use Maturity Level: 2 Computable Name: ConditionCategoryRemark
Other Identifiers: OID:2.16.840.1.113883.4.642.40.29.42.1

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

Context of Use

This extension may be used on the following element(s):

  • Element ID MeasureReport.group

Usage info

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Complex Extension: The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

  • author: Identifier, string: An Extension
  • authorOrganization: Identifier, string, Reference: An Extension
  • authorSoftware: Identifier, string: An Extension
  • authorDatetime: dateTime: An Extension
  • text: string: An Extension
  • code: CodeableConcept: An Extension
  • reasonCode: CodeableConcept: An Extension
  • relatedData: Identifier, Reference: An Extension
  • qualifyingDxCode: CodeableConcept: Diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. A string data type is supported
  • qualifyingDxList: string: A text list of diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available.

Maturity: 2

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... Slices for extension Content/Rules for all slices
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
... value[x] 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

  • author: Identifier, string: An Extension
  • authorOrganization: Identifier, string, Reference: An Extension
  • authorSoftware: Identifier, string: An Extension
  • authorDatetime: dateTime: An Extension
  • text: string: An Extension
  • code: CodeableConcept: An Extension
  • reasonCode: CodeableConcept: An Extension
  • relatedData: Identifier, Reference: An Extension
  • qualifyingDxCode: CodeableConcept: Diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. A string data type is supported
  • qualifyingDxList: string: A text list of diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available.

Maturity: 2

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... Slices for extension Content/Rules for all slices
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
... value[x] 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:code.value[x]extensibleCodingGapRemark(a valid code from Coding Gap Remark Codes)
http://hl7.org/fhir/us/davinci-ra/ValueSet/coding-gap-remark
From this IG
Extension.extension:reasonCode.value[x]extensibleRemarkReason(a valid code from Remark Reason Codes)
http://hl7.org/fhir/us/davinci-ra/ValueSet/remark-reason
From this IG
Extension.extension:qualifyingDxCode.value[x]preferredUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ra-2errorExtensionA remark shall include an author, an authorOrganization, or an authorSoftware
: extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()