Da Vinci Risk Adjustment Implementation Guide
2.0.0 - STU2 United States of America flag

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

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Da Vinci Risk Adjustment Implementation Guide Home Page
... 2 Methodology
.... 2.1 General Guidance
.... 2.2 Report Generation
.... 2.3 Report Query
.... 2.4 Submit Data To Payer
.... 2.5 Add Remark to Condition Category
... 3 Digital Condition Category (dCC)
... 4 Profiles
... 5 Extensions
... 6 Terminology
... 7 Operation
... 8 Capability Statement
... 9 Examples
... 10 Glossary
... 11 Downloads
... 12 Change Log
... 13 Artifacts Summary
.... 13.1 Risk Adjustment Data Submission Client Capability Statement
.... 13.2 Risk Adjustment Data Submission Server Capability Statement
.... 13.3 Risk Adjustment Reporting Client Capability Statement
.... 13.4 Risk Adjustment Reporting Server Capability Statement
.... 13.5 Evaluate Measure
.... 13.6 measurereport-category
.... 13.7 Risk Adjustment Data Exchange MeasureReport
.... 13.8 Risk Adjustment Coding Gap Report Bundle
.... 13.9 Risk Adjustment Coding Gap MeasureReport
.... 13.10 Risk Adjustment Model Measure
.... 13.11 RA Parameters ccRemark Patch Profile
.... 13.12 Patient Group
.... 13.13 Condition Category Remark
.... 13.14 Risk Adjustment Condition Category Type
.... 13.15 Risk Adjustment Clinical Data Collection Deadline
.... 13.16 Confidence Scale
.... 13.17 Diagnosis Code
.... 13.18 Evidence Status
.... 13.19 Risk Adjustment Evidence Status Date
.... 13.20 Group Reference
.... 13.21 Hierarchical Status
.... 13.22 Payer Coding Gap Report Id
.... 13.23 Reporting Vendor Extension
.... 13.24 Risk Adjustment Condition Category Type ValueSet
.... 13.25 Coding Gap Remark
.... 13.26 Confidence Scale Value Set
.... 13.27 Risk Adjustment Evidence Status ValueSet
.... 13.28 Risk Adjustment Hierarchical Status ValueSet
.... 13.29 Remark Reason
.... 13.30 Sample CMS Hierarchical Condition Category
.... 13.31 Risk Adjustment Condition Category Type CodeSystem
.... 13.32 Coding Gap Remark CodeSystem
.... 13.33 Risk Adjustment Evidence Status CodeSystem
.... 13.34 Risk Adjustment Hierarchical Status CodeSystem
.... 13.35 Remark Reason CodeSystem
.... 13.36 ra-bundle01: Risk Adjustment Bundle
.... 13.37 ra-group01: Risk Adjustment Patient Group
.... 13.38 ra-group02: Risk Adjustment Patient Group
.... 13.39 ra-measurereport01: Risk Adjustment Measure Report
.... 13.40 ra-measurereport01-with-remark: Risk Adjustment Measure Report with Condition Category Remark
.... 13.41 ra-measurereport02: Risk Adjustment Measure Report
.... 13.42 ra-measurereport03: Risk Adjustment Measure Report for HCC V24 for Patient 02
.... 13.43 ra-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03
.... 13.44 ra-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03
.... 13.45 ra-measurereport06: Risk Adjustment Measure Report for RxHCC V5 for Patient02
.... 13.46 Condition01pat03: Other artificial openings of gastrointestinal tract status
.... 13.47 Condition02pat01: Diabetes mellitus due to underlying condition with other diabetic kidney complication
.... 13.48 Condition03pat01: Chronic obstructive pulmonary disease with (acute) exacerbation
.... 13.49 Condition04pat03: Chronic obstructive pulmonary disease with (acute) exacerbation
.... 13.50 Condition05pat03: Unspecified protein-calorie malnutrition
.... 13.51 Condition06pat03: Crohn's disease of large intestine with unspecified complicationss
.... 13.52 Condition07pat03: Other persistent atrial fibrillation
.... 13.53 Condition08pat01: Bipolar disorder, current episode mixed, mild
.... 13.54 Condition09pat01: Allergic bronchopulmonary aspergillosis
.... 13.55 Condition10pat01: Long term (current) use of insulin
.... 13.56 Condition11pat01: Acute pulmonary edema
.... 13.57 Condition12pat01: Manic episode, unspecified
.... 13.58 Condition15pat03: Diabetes mellitus due to underlying condition with diabetic chronic kidney diseases
.... 13.59 Condition16pat03: Dependence on renal dialysis
.... 13.60 Condition17pat01: Body mass index [BMI] 45.0-49.9, adult
.... 13.61 Condition18pat01: Longstanding persistent atrial fibrillation
.... 13.62 ConditionR01pat01: Cystic fibrosis with other intestinal manifestations
.... 13.63 Condition21pat03: Type 2 diabetes mellitus without complications
.... 13.64 Condition22pat03: Other acute kidney failure
.... 13.65 Condition23pat03: Chronic kidney disease, stage 5
.... 13.66 Condition31pat02: Typical atrial flutter
.... 13.67 Condition32pat03: Chronic pulmonary embolism
.... 13.68 Condition33pat01: Respiratory arrest
.... 13.69 Condition35pat03: Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
.... 13.70 Condition42pat03: Other artificial openings of gastrointestinal tract status
.... 13.71 Condition43pat01: Diabetes mellitus due to underlying condition with other diabetic kidney complication
.... 13.72 Condition44pat01: Allergic bronchopulmonary aspergillosis
.... 13.73 Documentreference01pat01: Outpatient Note
.... 13.74 Encounter on 20210714
.... 13.75 Encounter on 20210131
.... 13.76 Encounter on 20210926
.... 13.77 Encounter on 20201218
.... 13.78 Encounter on 20200303
.... 13.79 Encounter on 20200917
.... 13.80 Encounter on 20190207
.... 13.81 Encounter on 20170203
.... 13.82 Encounter on 20210327
.... 13.83 Encounter on 20201102
.... 13.84 Encounter on 20200808
.... 13.85 Encounter on 20210727
.... 13.86 Encounter on 20210823
.... 13.87 Encounter on 20210130
.... 13.88 Encounter on 20210701
.... 13.89 Encounter on 20210806
.... 13.90 Encounter on 20210212
.... 13.91 Encounter on 20200210
.... 13.92 Encounter on 20190210
.... 13.93 Encounter on 20170118
.... 13.94 Encounter on 20180721
.... 13.95 Encounter on 2021-10-15
.... 13.96 Observation: Trypsin [Mass/volume] in Serum or Plasma result from 20190617
.... 13.97 Observation: Creatinine Result from 20210728
.... 13.98 Observation: PHQ9 from 20190823
.... 13.99 Trypsin [Mass/volume] in Serum or Plasma from 20170617
.... 13.100 Laboratory01: XYZ Laboratory
.... 13.101 Vendor01: Best RA Vendor
.... 13.102 Organization01: ABC Payer
.... 13.103 Organization: Community Urgent Care
.... 13.104 Organization: GHH Outpatient Clinic
.... 13.105 Organization: Community HealthCenter
.... 13.106 Organization: Risk Adjustment Author
.... 13.107 Risk Adjustement Measure Report Patch
.... 13.108 Risk Adjustement Measure Report Patch With Multiple Values
.... 13.109 Patient01: Eve Everywoman
.... 13.110 Patient02: Adam Everyman
.... 13.111 Patient03: Nelda Nuclear
.... 13.112 Practitioner: Harold Hippocrates
.... 13.113 Practitioner: Patrick Pump
.... 13.114 Practitioner: Otto Osler
.... 13.115 ra-datax-measurereport01: Risk Adjustment Data Exchange Measure Report
.... 13.116 Submit Data for Risk Adjustement Data Exchange MeasureReport
.... 13.117 Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)
.... 13.118 Risk Adjustment Model Version 21 - CMS Hierarchical Category Condition (CMS-HCC)
.... 13.119 Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC)