Da Vinci Risk Adjustment Implementation Guide
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This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v2.0.0-ballot: STU2 (v2.0.0) Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Example MeasureReport: ra-measurereport01-with-annotation: Risk Adjustment Measure Report with Annotation

Generated Narrative: MeasureReport

Resource MeasureReport "ra-measurereport01-with-annotation"

Profile: Risk Adjustment Coding Gap MeasureReport

Risk Adjustment Clinical Data Collection Deadline: 2022-03-31

status: complete

type: individual

measure: Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)

subject: Patient/ra-patient01 " EVERYWOMAN"

date: 2021-10-18

reporter: Organization/ra-payer01 "ABC Payer"

period: 2021-01-01 --> 2021-09-30

group

id

group-001

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Risk Adjustment Evidence Status Date: 2021-04-01

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: HCC 18: Diabetes with Chronic Complications (CMS Hierarchical Condition Categories[24]#18 "Diabetes with Chronic Complications")

group

id

group-002

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-29

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: HCC 111: Chronic Obstructive Pulmonary Disease (CMS Hierarchical Condition Categories[24]#111 "Chronic Obstructive Pulmonary Disease")

group

id

group-003

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Open Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#open-gap)

Risk Adjustment Evidence Status Date: 2020-07-15

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

Annotation

url

annotator

value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

url

annotated

value: 2021-11-01

url

text

value: Diagnosis added

url

code

value: Assessed and present (Coding Gap Annotation CodeSystem#assessed-present)

url

relatedData

value: id: CLM23333

code: HCC 59: Major Depressive, Bipolar, and Paranoid Disorders (CMS Hierarchical Condition Categories[24]#59 "Major Depressive, Bipolar, and Paranoid Disorders")

group

id

group-004

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Risk Adjustment Evidence Status Date: 2021-04-27

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: HCC 112: Fibrosis of lung and other chronic lung disorders (CMS Hierarchical Condition Categories[24]#112 "Fibrosis of lung and other chronic lung disorders")

group

id

group-005

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-27

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

code: HCC 19: Diabetes without Complications (CMS Hierarchical Condition Categories[24]#19 "Diabetes without Complications")

group

id

group-006

Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

Evidence Status: Open Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#open-gap)

Risk Adjustment Evidence Status Date: 2020-12-15

Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

Annotation

url

annotator

value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

url

annotated

value: 2021-11-01

url

text

value: Continue evaluation

url

code

value: Deferred (Coding Gap Annotation CodeSystem#deferred)

code: HCC 84: Cardio-Respiratory Failure and Shock (CMS Hierarchical Condition Categories[24]#84 "Cardio-Respiratory Failure and Shock")

group

id

group-007

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

Risk Adjustment Evidence Status Date: 2021-03-15

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: HCC 22: Morbid Obesity (CMS Hierarchical Condition Categories[24]#22 "Morbid Obesity")

group

id

group-008

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-27

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: HCC 96: Specified Heart Arrhythmias (CMS Hierarchical Condition Categories[24]#96 "Specified Heart Arrhythmias")

group

id

group-009

Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

Evidence Status: Open Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#open-gap)

Risk Adjustment Evidence Status Date: 2020-07-15

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

Confidence Scale: Medium (SNOMED CT#255508009)

Annotation

url

annotator

value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

url

annotated

value: 2021-11-01

url

text

value: Not diagnosed

url

code

value: Assessed and not present (Coding Gap Annotation CodeSystem#assessed-not-present)

url

relatedData

value: id: 432203939

code: HCC 110: Cystic Fibrosis (CMS Hierarchical Condition Categories[24]#110 "Cystic Fibrosis")

group

id

group-010

Risk Adjustment Suspect Type: Net-New Condition Category (Risk Adjustment Suspect Type CodeSystem#net-new)

Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

Risk Adjustment Evidence Status Date: 2021-09-28

Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

code: HCC 83: Respiratory Arrest (CMS Hierarchical Condition Categories[24]#83 "Respiratory Arrest")

evaluatedResource: