abstractbaseDefinitioncopyrightdate- Values Differ
description- Values Differ
experimentalfhirVersionjurisdiction
jurisdiction[0]kindname- Values Differ
publisher- Values Differ
purposestatustitle- Values Differ
typeurlversion- Values Differ
| Left: | Risk Adjustment Coding Gap Report Profile (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport) |
| Right: | Risk Adjustment Coding Gap MeasureReport (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport) |
| Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '2.0.0' |
| Information | StructureDefinition.name | Values for name differ: 'RiskAdjustmentCodingGapReport' vs 'RiskAdjustmentCodingGapMeasureReport' |
| Information | StructureDefinition.title | Values for title differ: 'Risk Adjustment Coding Gap Report Profile' vs 'Risk Adjustment Coding Gap MeasureReport' |
| Information | StructureDefinition.date | Values for date differ: '2022-06-16T14:23:36+00:00' vs '2024-12-10T22:27:38+00:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 Clinical Quality Information Work Group' vs 'HL7 International / Clinical Quality Information' |
| Information | StructureDefinition.short | Values for short differ: 'This is a Risk Adjustment Coding Gap Report.' vs 'This is a risk adjustment coding gap report.' |
| Information | StructureDefinition.definition | Values for definition differ: 'This is a Risk Adjustment Coding Gap Report of a patient/member using a specific version of a particular Risk Adjustment model.' vs 'This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model.' |
| Information | StructureDefinition.short | Values for short differ: 'This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered.' vs 'Extension' |
| Information | StructureDefinition.definition | Values for definition differ: 'This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer.' vs 'An Extension' |
| Warning | MeasureReport.extension | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Information | MeasureReport.extension | Element minimum cardinalities differ: '0' vs '1' |
| Information | MeasureReport.extension | Element maximum cardinalities differ: '1' vs '2147483647' |
| Information | StructureDefinition.short | Values for short differ: 'The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report' vs 'The type code is fixed to 'individual' for a risk adjustment coding gap report' |
| Information | StructureDefinition.short | Values for short differ: 'This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.' vs 'This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28.' |
| Information | MeasureReport.group.extension | Element minimum cardinalities differ: '0' vs '1' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/MeasureReport | ||
| copyright | Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License | ||
| date | 2022-06-16T14:23:36+00:00 | 2024-12-10T22:27:38+00:00 |
|
| description | This risk adjustment coding gap report profile is based on the [MeasureReport](http://hl7.org/fhir/R4/measurereport.html) to represent a risk adjustment coding gap report. | This profile is based on the [MeasureReport](http://hl7.org/fhir/R4/measurereport.html) to represent a risk adjustment coding gap report. Payer runs risk adjustment engine and uses this profile to represent the risk adjustment Condition Category (CC) coding gaps and their detailed information for a patient. |
|
| experimental | false | ||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | RiskAdjustmentCodingGapReport | RiskAdjustmentCodingGapMeasureReport |
|
| publisher | HL7 Clinical Quality Information Work Group | HL7 International / Clinical Quality Information |
|
| purpose | |||
| status | active | ||
| title | Risk Adjustment Coding Gap Report Profile | Risk Adjustment Coding Gap MeasureReport |
|
| type | MeasureReport | ||
| url | http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport | ||
| version | 1.0.0 | 2.0.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 MeasureReport | C | 0..* | MeasureReport | This is a Risk Adjustment Coding Gap Report. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components | C | 0..* | MeasureReport | This is a risk adjustment coding gap report. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components | |||||||||
 id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
 ra-clinicalDataCollectionDeadline | S | 0..1 | date | This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline | 1..* | Extension | Extension Slice: Unordered, Open by value:url |
| |||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport | Σ | 0..* | Identifier | Additional identifier for the MeasureReport | |||||||||
| status | ?!SΣ | 1..1 | code | complete | pending | error Binding: ?? (required): The status of the measure report. | ?!SΣ | 1..1 | code | complete | pending | error Binding: ?? (required): The status of the measure report. | |||||||||
| type | SΣC | 1..1 | code | The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Binding: ?? (required): The type of the measure report. Fixed Value: individual | SΣC | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Binding: ?? (required): The type of the measure report. Fixed Value: individual | |||||||||
| measure | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24. | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. | |||||||||
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for | |||||||||
| date | SΣ | 1..1 | dateTime | When the report was generated | SΣ | 1..1 | dateTime | When the report was generated | |||||||||
| reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | |||||||||
 period | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) | |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 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 | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| start | SΣC | 1..1 | dateTime | Starting time with inclusive boundary | SΣC | 1..1 | dateTime | Starting time with inclusive boundary | |||||||||
| end | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | |||||||||
| improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: ?? (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: ?? (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. | |||||||||
| group | SC | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category. | SC | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category. | |||||||||
| id | S | 1..1 | string | Unique id for inter-element referencing | S | 1..1 | string | Unique id for inter-element referencing | |||||||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | 1..* | Extension | Extension Slice: Unordered, Open by value:url |
| ||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| code | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: ?? (example) | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: ?? (example) | |||||||||
| population | 0..* | BackboneElement | The populations in the group | 0..* | BackboneElement | The populations in the group | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: ?? (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: ?? (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | |||||||||
| count | 0..1 | integer | Size of the population | 0..1 | integer | Size of the population | |||||||||||
| subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||||||||
| measureScore | Σ | 0..1 | Quantity | What score this group achieved | Σ | 0..1 | Quantity | What score this group achieved | |||||||||
 stratifier | 0..* | BackboneElement | Stratification results | 0..* | BackboneElement | Stratification results | |||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| code | 0..1 | CodeableConcept | What stratifier of the group | 0..1 | CodeableConcept | What stratifier of the group | |||||||||||
| stratum | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| value | 0..1 | CodeableConcept | The stratum value, e.g. male | 0..1 | CodeableConcept | The stratum value, e.g. male | |||||||||||
| component | 0..* | BackboneElement | Stratifier component values | 0..* | BackboneElement | Stratifier component values | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| code | 1..1 | CodeableConcept | What stratifier component of the group | 1..1 | CodeableConcept | What stratifier component of the group | |||||||||||
| value | 1..1 | CodeableConcept | The stratum component value, e.g. male | 1..1 | CodeableConcept | The stratum component value, e.g. male | |||||||||||
| population | 0..* | BackboneElement | Population results in this stratum | 0..* | BackboneElement | Population results in this stratum | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: ?? (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: ?? (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | |||||||||||
| count | 0..1 | integer | Size of the population | 0..1 | integer | Size of the population | |||||||||||
| subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||||||||
| measureScore | 0..1 | Quantity | What score this stratum achieved | 0..1 | Quantity | What score this stratum achieved | |||||||||||
| evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap. | S | 0..* | Reference(Resource) | An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap. | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 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 | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| reference | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||||||
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||
| display | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
| Documentation for this format | |||||||||||||||||