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
Once a Risk Adjustment Coding Gap Report is generated, a Condition Category Remark can be added to the MeasureReport. Here are some ways this remark may be used:
qualifyingDxCode) when proprietary risk models are used by the payer and the mappings of ICD-10-codes to Condition Categories are not readily available to the provider.Note: The Condition Category Remark extension is not intended to change the status of a Condition Category gap. To change the status, follow the Submit Data to Payer section of this guidance. Note that both a Condition Category remark and Submit Data to Payer can be generated at the time the Provider sees the patient if that is appropriate.
This Condition Category Remark extension is added to the Risk Adjustment Coding Gap Report within the MeasureReport.group element. This allows for a remark be added at the Condition Category code level. The Condition Category Remark is a Complex extension and can repeat; it has several fields:
author, an authorOrganization, or an authorSoftware
author indicates the person who provided the remark. It can be an identifier such as an NPI or a person’s name.authorOrganization which can be an identifier such as a TIN or NPI for the organization or can be a text name of the Organization.authorSoftware is the software system that generated the remark either an identifier for the system or a system name.authorDatetime when the remark was madetext a free text remarkcode a coded remark indicating what happened at the time of the remark, such as when a provider sees the patient and decides a condition is present; the code would be “assessed-present”. The code list which is extensible includes assessed-present, assessed-not-present, in-progress, not-assessed, not-presented, deferred, and not-ingested.reasonCode reason why remark is added. The value set which is extensible includes never-had-condition, inactive-condition, and inapplicable-gap.relatedDataIentifier an identifier field that can be used to link to a claim or document such as a Continuity of Care Document (CCD) that the provider is sending via another method or transaction.qualifyingDxCode diagnoses that would be classified under this Condition Category as defined by the risk adjustment model. This would be added by the payer or an entity working on behalf of the payer.qualifyingDxList: a list of diagnoses classified under this Condition Category as defined by the risk adjustment model provided as a string. Added by the payer or an entity working on behalf of the payer.The Provider’s system being used SHALL NOT change any other part of the original Risk Adjustment Coding Gap Report and can only add the Condition Category Remark to the appropriate MeasureReport.group(s). If a provider wants to share data with the Payer in order to change a gap status, they should use the Submit Data to Payer process.
If a payer or someone acting on behalf of the payer like a risk adjustment coder is adding a remark to the report, they would update the report on their server.
If a provider, the provider’s electronic heath record or a risk adjustment coder working on his behalf adds a Remark to the Risk Adjustment Coding Gap Report, the ccRemark can be added to the Report with the Patch process or the entire MeasureReport with the added ccRemark posted to the Provider’s system.
The Provider may choose to send the Condition Category remark only to the Payer using a light weight approach rather than sending the entire MeasureReport resource. They can do this using the PATCH operation.
A RA Parameters ccRemark Patch Profile is defined to specify the structures of using the Parameter resource to send the remark using the PATCH operation.
This implementation guide does not direct any action be taken by the Payer upon receipt of a Risk Adjustment Coding Gap Report with added Condition Category remark(s).
After a Payer generates a subsequent Risk Adjustment Coding Gap Report, in their role as Reporting Server they can choose to include the Condition Category remarks as they see fit. This might include adding the remarks only if received from the same Provider and can include any remarks all the way up to including all Condition Category remarks received from any provider. The Payer is not required to include any Condition Category remarks on subsequently generated Risk Adjustment Coding Gap Report.
PUT [base]/MeasureReport/[id]
Scenario:
A Provider receives a Risk Adjustment Gaps Report from a Payer. After seeing the patient, Remarks are added to the full report and it is updated at the Payer.
PUT Risk Adjustment Coding Gaps Report with Remarks
PUT [base]/MeasureReport/ra-measurereport01
Request body
{
"resourceType": "MeasureReport",
"id": "ra-measurereport01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline",
"valueDate": "2022-03-31"
}
],
"status": "complete",
"type": "individual",
"measure": "https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample01",
"subject": {
"reference": "Patient/ra-patient01"
},
"date": "2021-10-18",
"reporter": {
"reference": "Organization/ra-payer01"
},
"period": {
"start": "2021-01-01",
"end": "2021-09-30"
},
"group": [
{
"id": "group-001",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "18",
"display": "Diabetes with Chronic Complications"
}
],
"text": "HCC 18: Diabetes with Chronic Complications"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "closed-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-04-01"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-002",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "111",
"display": "Chronic Obstructive Pulmonary Disease"
}
],
"text": "HCC 111: Chronic Obstructive Pulmonary Disease"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "pending",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-09-29"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-003",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "59",
"display": "Major Depressive, Bipolar, and Paranoid Disorders"
}
],
"text": "HCC 59: Major Depressive, Bipolar, and Paranoid Disorders"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "open-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2020-07-15"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark",
"extension": [
{"url": "author",
"valueIdentifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567890"
}
},
{"url": "authorDatetime",
"valueDateTime": "2021-11-01"
},
{"url": "text",
"valueString": "Diagnosis added"
},
{"url": "code",
"valueCodeableConcept" : {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
"code": "assessed-present",
"display": "Assessed and present"
}
]
}
},
{"url": "relatedDataIdentifier",
"valueIdentifier": {
"system": "http://example.org/fhir/myclaimno",
"value": "CLM23333"}
}
]
}
]
},
{
"id": "group-004",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "112",
"display": "Fibrosis of lung and other chronic lung disorders"
}
],
"text": "HCC 112: Fibrosis of lung and other chronic lung disorders"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "closed-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-04-27"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-005",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "19",
"display": "Diabetes without Complications"
}
],
"text": "HCC 19: Diabetes without Complications"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "pending",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-09-27"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-006",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "84",
"display": "Cardio-Respiratory Failure and Shock"
}
],
"text": "HCC 84: Cardio-Respiratory Failure and Shock"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "historic",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "open-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2020-12-15"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark",
"extension": [
{"url": "author",
"valueIdentifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567890"
}
},
{"url": "authorDatetime",
"valueDateTime": "2021-11-01"
},
{"url": "text",
"valueString": "Continue evaluation"
},
{"url": "code",
"valueCodeableConcept" : {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
"code": "deferred",
"display": "Deferred"
}
]
}
}
]
}
]
},
{
"id": "group-007",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "22",
"display": "Morbid Obesity"
}
],
"text": "HCC 22: Morbid Obesity"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "suspected",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "closed-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-03-15"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-008",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "96",
"display": "Specified Heart Arrhythmias"
}
],
"text": "HCC 96: Specified Heart Arrhythmias"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "suspected",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "pending",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-09-27"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
},
{
"id": "group-009",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "110",
"display": "Cystic Fibrosis"
}
],
"text": "HCC 110: Cystic Fibrosis"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "suspected",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "open-gap",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2020-07-15"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale",
"valueCodeableConcept": {
"coding": [
{
"code": "255508009",
"system": "http://snomed.info/sct",
"display": "Medium"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark",
"extension": [
{"url": "author",
"valueIdentifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567890"
}
},
{"url": "authorDatetime",
"valueDateTime": "2021-11-01"
},
{"url": "text",
"valueString": "Not diagnosed"
},
{"url": "code",
"valueCodeableConcept" : {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
"code": "assessed-not-present"
}
]
}
},
{"url": "relatedDataIdentifier",
"valueIdentifier": {
"system": "http://example.org/fhir/mychart",
"value": "432203939"}
}
]
}
]
},
{
"id": "group-010",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/cmshcc",
"version": "24",
"code": "83",
"display": "Respiratory Arrest"
}
],
"text": "HCC 83: Respiratory Arrest"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
"valueCodeableConcept": {
"coding": [
{
"code": "net-new",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "pending",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
"valueDate": "2021-09-28"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
"valueCodeableConcept": {
"coding": [
{
"code": "applied-not-superseded",
"system": "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"
}
]
}
}
]
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-001"
}
],
"reference": "Condition/ra-condition02pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-002"
}
],
"reference": "Condition/ra-condition03pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-003"
}
],
"reference": "Condition/ra-condition08pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-004"
}
],
"reference": "Condition/ra-condition09pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-005"
}
],
"reference": "Condition/ra-condition10pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-006"
}
],
"reference": "Condition/ra-condition11pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-007"
}
],
"reference": "Condition/ra-condition17pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-008"
}
],
"reference": "Condition/ra-condition18pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-010"
}
],
"reference": "Condition/ra-condition33pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-001"
}
],
"reference": "Condition/ra-condition43pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-004"
}
],
"reference": "Condition/ra-condition44pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-001"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-007"
}
],
"reference": "Encounter/ra-encounter02pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-002"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-005"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-008"
},
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-010"
}
],
"reference": "Encounter/ra-encounter03pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-003"
}
],
"reference": "Encounter/ra-encounter08pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-004"
}
],
"reference": "Encounter/ra-encounter09pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-006"
}
],
"reference": "Encounter/ra-encounter11pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-001"
}
],
"reference": "Encounter/ra-encounter43pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-004"
}
],
"reference": "Encounter/ra-encounter44pat01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
"valueString": "group-009"
}
],
"reference": "Observation/ra-obs21pat01"
}
]
}
Response
HTTP/1.1 200 ok
PATCH [base]/MeasureReport/[id]
Scenario:
A Provider receives a Risk Adjustment Gaps Report from a Payer. The Provider uses PATCH to update the Report at the Payer with just the Remark information they add at time of visit.
PATCH Risk Adjustment Coding Gaps Report with Remarks
PATCH [base]/MeasureReport/ra-measurereport01
Request body
{
"resourceType": "Parameters",
"id": "ra-measurereport01",
"parameter": [
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "add"
},
{
"name": "path",
"valueString": "MeasureReport.group.where(id='group-001')"
},
{
"name": "name",
"valueString": "extension"
},
{
"name": "value",
"part": [
{
"name": "url",
"valueUri": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
},
{
"name": "extension",
"part": [
{
"name": "url",
"valueUri": "authorDatetime"
},
{
"name": "value",
"valueDateTime": "2023-12-11"
}
]
}
]
}
]
},
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "add"
},
{
"name": "path",
"valueString": "MeasureReport.group.where(id='group-001')"
},
{
"name": "name",
"valueString": "extension"
},
{
"name": "value",
"part": [
{
"name": "url",
"valueUri": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
},
{
"name": "extension",
"part": [
{
"name": "url",
"valueUri": "text"
},
{
"name": "value",
"valueString": "Example author text for a condition category."
}
]
}
]
}
]
},
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "add"
},
{
"name": "path",
"valueString": "MeasureReport.group.where(id='group-002')"
},
{
"name": "name",
"valueString": "extension"
},
{
"name": "value",
"part": [
{
"name": "url",
"valueUri": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
},
{
"name": "extension",
"part": [
{
"name": "url",
"valueUri": "authorDatetime"
},
{
"name": "value",
"valueDateTime": "2024-01-07"
}
]
}
]
}
]
}
]
}
Response
HTTP/1.1 200 ok
IG © 2021+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.davinci-ra#2.0.0 based on FHIR 4.0.1. Generated 2024-11-18
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