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 3.0.0-ballot 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
Language: en
Bundle ra-measurereport-with-remark of type collection
Entry 1 - fullUrl = http://example.org/fhir/MeasureReport/ra-measurereport01-with-remark
Resource MeasureReport:
Language: en
Profile: Risk Adjustment Coding Gap MeasureReport with Remark
Measure Report Category: Risk Adjustment
Clinical Data Collection Deadline Extension: 2022-03-31
status: Complete
type: Individual
measure: Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)
subject: Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345 (use: usual, ))
date: 2021-10-18
reporter: Organization ABC Payer
period: 2021-01-01 --> 2021-09-30
group
id
group-001Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Closed Condition Category Gap
Evidence Status Date Extension: 2021-04-01
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
Condition Category Remark Extension
- author: NPI/1234567890
code: HCC 18: Diabetes with Chronic Complications
group
id
group-002Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Pending Condition Category Gap
Evidence Status Date Extension: 2021-09-29
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
Diagnosis Code Extension: Moderate major depression
code: HCC 111: Chronic Obstructive Pulmonary Disease
group
id
group-003Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Open Condition Category Gap
Evidence Status Date Extension: 2020-07-15
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
Condition Category Remark Extension
- author: NPI/1234567890
- text: Diagnosis added
- code: Assessed and present
- relatedData:
http://example.org/fhir/myclaimno/CLM23333code: HCC 59: Major Depressive, Bipolar, and Paranoid Disorders
group
id
group-004Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Closed Condition Category Gap
Evidence Status Date Extension: 2021-04-27
Hierarchical Status Extension: Hierarchies applied and Condition Category is superseded
code: HCC 112: Fibrosis of lung and other chronic lung disorders
group
id
group-005Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Pending Condition Category Gap
Evidence Status Date Extension: 2021-09-27
Hierarchical Status Extension: Hierarchies applied and Condition Category is superseded
code: HCC 19: Diabetes without Complications
group
id
group-006Condition Category Type Extension: Historic Condition Category Gap
Evidence Status Extension: Open Condition Category Gap
Evidence Status Date Extension: 2020-12-15
Hierarchical Status Extension: Hierarchies applied and Condition Category is superseded
Condition Category Remark Extension
- author: NPI/1234567890
- authorDatetime: 2021-11-01
- text: Continue evaluation
- code: Deferred
code: HCC 84: Cardio-Respiratory Failure and Shock
group
id
group-007Condition Category Type Extension: Suspected Condition Category Gap
Evidence Status Extension: Closed Condition Category Gap
Evidence Status Date Extension: 2021-03-15
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
Condition Category Remark Extension
- author: NPI/1234567890
- authorDatetime: 2021-11-01
code: HCC 22: Morbid Obesity
group
id
group-008Condition Category Type Extension: Suspected Condition Category Gap
Evidence Status Extension: Pending Condition Category Gap
Evidence Status Date Extension: 2021-09-27
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
code: HCC 96: Specified Heart Arrhythmias
group
id
group-009Condition Category Type Extension: Suspected Condition Category Gap
Evidence Status Extension: Open Condition Category Gap
Evidence Status Date Extension: 2020-07-15
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
Confidence Scale Extension: Medium
Condition Category Remark Extension
- author: NPI/1234567890
- authorDatetime: 2021-11-01
- text: Not diagnosed
- code: Assessed and not present
- relatedData:
http://example.org/fhir/mychart/432203939code: HCC 110: Cystic Fibrosis
group
id
group-010Condition Category Type Extension: Net-New Condition Category
Evidence Status Extension: Pending Condition Category Gap
Evidence Status Date Extension: 2021-09-28
Hierarchical Status Extension: Hierarchies applied and Condition Category is not superseded
code: HCC 83: Respiratory Arrest
evaluatedResource:
- Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication
- Condition Chronic obstructive pulmonary disease with (acute) exacerbation
- Condition Bipolar disorder, current episode mixed, mild
- Condition Allergic bronchopulmonary aspergillosis
- Condition Long term (current) use of insulin
- Condition Acute pulmonary edema
- Condition Body mass index [BMI] 45.0-49.9, adult
- Condition Longstanding persistent atrial fibrillation
- Condition Respiratory arrest
- Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication
- Condition Allergic bronchopulmonary aspergillosis
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-01-31 --> 2021-01-31
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-09-26 --> 2021-09-26
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-02-03 --> 2017-02-03
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-03-27 --> 2021-03-27
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2020-11-02 --> 2020-11-02
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2019-02-10 --> 2019-02-10
- Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-01-18 --> 2017-01-18
- Observation Trypsin [Mass/volume] in Serum or Plasma