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

## : Sample CMS Hierarchical Condition Category - XML Representation

Page standards status: Trial-use | Maturity Level: 2

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    <ValueSet xmlns="http://hl7.org/fhir">
      <id value="sample-cmshcc"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet sample-cmshcc</b></p><a name="sample-cmshcc"> </a><a name="hcsample-cmshcc"> </a><ul><li>Include these codes as defined in <a href="http://terminology.hl7.org/5.5.0/CodeSystem-cmshcc.html"><code>http://terminology.hl7.org/CodeSystem/cmshcc</code></a><span title="Version is not explicity stated. No matching Code System found"> version Not Stated (use latest from terminology server)</span><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td>22</td><td>Morbid Obesity</td></tr><tr><td>88</td><td>Angina Pectoris</td></tr><tr><td>112</td><td>Fibrosis of Lung and Other Chronic Lung Disorders</td></tr></table></li></ul></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="cqi"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="2">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/davinci-ra/ImplementationGuide/davinci-ra"/>
          </extension>
        </valueInteger>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/davinci-ra/ImplementationGuide/davinci-ra"/>
          </extension>
        </valueCode>
      </extension>
      <url value="http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.29.48.7"/>
      </identifier>
      <version value="2.1.0"/>
      <name value="SampleCMSHCC"/>
      <title value="Sample CMS Hierarchical Condition Category"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2025-11-20T19:49:53+00:00"/>
      <publisher value="HL7 International / Clinical Quality Information"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/cqi"/>
        </telecom>
      </contact>
      <description
                   value="This is a sample of the concepts that can be found in the CMS Hierarchical Condition Categories (CMS-HCC) code system version 24. The source of the codes included in this example was published at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories (CCs) that predict costs well. The condition categories (CCs) are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the Condition Categories (CCs) to capture the most costly diagnoses. Hierarchy logic is imposed on certain Condition Categories (CCs) to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC."/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
          <display value="United States of America"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
      <compose>
        <include>
          <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
          <concept>
            <code value="22"/>
            <display value="Morbid Obesity"/>
          </concept>
          <concept>
            <code value="88"/>
            <display value="Angina Pectoris"/>
          </concept>
          <concept>
            <code value="112"/>
            <display value="Fibrosis of Lung and Other Chronic Lung Disorders"/>
          </concept>
        </include>
      </compose>
    </ValueSet>