Da Vinci Risk Adjustment Implementation Guide (STU1 Ballot)
0.1.0 - STU 1 Ballot

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions

CodeSystem: Risk Adjustment Suspect Type Code System

Summary

Defining URL:http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type
Version:0.1.0
Name:RiskAdjustmentSuspectTypeCodeSystem
Title:Risk Adjustment Suspect Type Code System
Status:Draft as of 12/6/21 10:33 PM
Definition:

This is a code system for Risk Adjustment suspect type to indicate whether it is a suspected Condition Category (CC) gap, a historic CC gap, or an unsuspected CC. Historic, suspected, and net-new are mutually exclusive.

Publisher:HL7 Clinical Quality Information Work Group
Copyright:

Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License

Content:Complete: All the concepts defined by the code system are included in the code system resource
Source Resource:XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

This code system http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type defines the following codes:

CodeDisplayDefinition
historic Historic Condition Category GapHistoric Condition Category (CC) Gap. Historic CC is based on data from a prior clinical evaluation period.
suspected Suspected Condtion Category GapSuspected Condition Category (CC) Gap. A member never has CC before, but when a Server runs a suspecting algorithm, suspected CCs are identified for the member.
net-new Net-New Condition CategoryNet-New Condition Category (CC). New Condition Category, not from suspected process or historic. A Net-New CC is documented for the first time during the clinical evaluation period for the risk adjustment model. Any CCs that are net new must be either closed-gap or pending, and can not be open-gap.