Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1

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: QualifyingCode Extension

Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode | Version: 2.1.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: QualifyingCode
Other Identifiers: OID:2.16.840.1.113883.4.642.40.29.42.21
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Diagnosis code(s) 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. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement.

Context of Use

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

- Element ID: `MeasureReport.group`

Usage info

Usages:

- Use this Extension: Risk Adjustment Coding Gap MeasureReport

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.

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Qualifying diagnosis code(s)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode"
value[x] |  | 0..1 |  | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
valueString |  |  | string |
valueCodeableConcept |  |  | CodeableConcept |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Qualifying diagnosis code(s)
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 | "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode"
value[x] |  | 0..1 |  | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
valueString |  |  | string |
valueCodeableConcept |  |  | CodeableConcept |
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type string, CodeableConcept: Diagnosis code(s) 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. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement.

Maturity: 2

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Qualifying diagnosis code(s)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode"
value[x] |  | 0..1 |  | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
valueString |  |  | string |
valueCodeableConcept |  |  | CodeableConcept |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Qualifying diagnosis code(s)
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 | "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode"
value[x] |  | 0..1 |  | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
valueString |  |  | string |
valueCodeableConcept |  |  | CodeableConcept |
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type string, CodeableConcept: Diagnosis code(s) 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. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement.

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`