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
| Page standards status: Trial-use | Maturity Level: 2 |
Definitions for the ra-qualifyingDxCode extension
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Diagnosis codes 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. Optional Extension Element - found in all resources. |
| Short | Qualifying diagnosis code(s)Optional Extensions Element |
| Comments | This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 2. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode |
| 4. Extension.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 0..1 |
| Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
| 6. Extension.value[x]:valueCodeableConcept | |
| Slice Name | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Diagnosis codes classified under a Condition Category as defined by the risk adjustment modelValue of extension |
| Control | 0..1 |
| Binding | Unless not suitable, these codes SHALL be taken from For codes, see USCoreConditionCodes (7.0.0) (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0) |
| Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 8. Extension.value[x]:valueCodeableConcept.extension:codeOptions | |
| Slice Name | codeOptions |
| Definition | A logical reference (i.e. a reference to ValueSet.url) to a value set (and optionally a version) that identifies a set of possible coded values for the element. This extension is used to convey a list of candidate codes when there is no formal code in the code system already defined that captures the intended set. For example, the concept of COVID preventative medications can be expressed as a value set because there is no specific code representing that concept. |
| Short | Qualifying diagnosis codes provided as a value set |
| Comments | This extension SHALL NOT be used when an appropriate higher level concept code exists. This extension cannot be used on an element with a required binding. When this extension is used on an element with an extensible binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set unless none of the codes in the bound value set apply to the concept being communicated (based on human review). When this extension appears on a CodeableConcept, the CodeableConcept SHALL have no codings, and the text of the CodeableConcept SHOULD include the title of the referenced value set. |
| Control | 0..1 |
| Type | Extension(Code Options) (Extension Type: canonical(ValueSet)) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Diagnosis codes 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. |
| Short | Qualifying diagnosis code(s) |
| Comments | This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending. |
| Control | 0..* |
| 2. Extension.url | |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Fixed Value | http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode |
| 4. Extension.valueCodeableConcept | |
| Short | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model |
| Binding | Unless not suitable, these codes SHALL be taken from USCoreConditionCodes (7.0.0) (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0) |
| Type | CodeableConcept |
| 6. Extension.valueCodeableConcept.extension:codeOptions | |
| Slice Name | codeOptions |
| Short | Qualifying diagnosis codes provided as a value set |
| Control | 0..1 |
| Type | Extension(Code Options) (Extension Type: canonical(ValueSet)) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Diagnosis codes 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. |
| Short | Qualifying diagnosis code(s) |
| Comments | This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 2. Extension.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 4. Extension.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode |
| 8. Extension.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 0..1 |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
| 10. Extension.value[x]:valueCodeableConcept | |
| Slice Name | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Diagnosis codes classified under a Condition Category as defined by the risk adjustment model |
| Control | 0..1 |
| Binding | Unless not suitable, these codes SHALL be taken from USCoreConditionCodes (7.0.0) (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0) |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 12. Extension.value[x]:valueCodeableConcept.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 14. Extension.value[x]:valueCodeableConcept.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 16. Extension.value[x]:valueCodeableConcept.extension:codeOptions | |
| Slice Name | codeOptions |
| Definition | A logical reference (i.e. a reference to ValueSet.url) to a value set (and optionally a version) that identifies a set of possible coded values for the element. This extension is used to convey a list of candidate codes when there is no formal code in the code system already defined that captures the intended set. For example, the concept of COVID preventative medications can be expressed as a value set because there is no specific code representing that concept. |
| Short | Qualifying diagnosis codes provided as a value set |
| Comments | This extension SHALL NOT be used when an appropriate higher level concept code exists. This extension cannot be used on an element with a required binding. When this extension is used on an element with an extensible binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set unless none of the codes in the bound value set apply to the concept being communicated (based on human review). When this extension appears on a CodeableConcept, the CodeableConcept SHALL have no codings, and the text of the CodeableConcept SHOULD include the title of the referenced value set. |
| Control | 0..1 |
| Type | Extension(Code Options) (Extension Type: canonical(ValueSet)) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 18. Extension.value[x]:valueCodeableConcept.coding | |
| Definition | A reference to a code defined by a terminology system. |
| Short | Code defined by a terminology system |
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
| Control | 0..* |
| Type | Coding |
| Is Modifier | false |
| Summary | true |
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. Extension.value[x]:valueCodeableConcept.text | |
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Short | Plain text representation of the concept |
| Comments | Very often the text is the same as a displayName of one of the codings. |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |