Da Vinci Risk Adjustment Implementation Guide
2.0.0-ballot - STU2 Ballot
Da Vinci Risk Adjustment Implementation Guide
2.0.0-ballot - STU2 Ballot
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 
<MeasureReport xmlns="http://hl7.org/fhir">
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<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MeasureReport</b><a name="ra-measurereport02"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MeasureReport "ra-measurereport02" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ra-measurereport.html">Risk Adjustment Coding Gap MeasureReport</a></p></div><p><b>Risk Adjustment Clinical Data Collection Deadline</b>: 2022-03-31</p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href="Measure-RAModelExample03.html">Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC)</a></p><p><b>subject</b>: <a href="Patient-ra-patient01.html">Patient/ra-patient01</a> " EVERYWOMAN"</p><p><b>date</b>: 2021-10-18</p><p><b>reporter</b>: <a href="Organization-ra-payer01.html">Organization/ra-payer01</a> "ABC Payer"</p><p><b>period</b>: 2021-01-01 --> 2021-09-30</p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-001</blockquote><p><b>Risk Adjustment Suspect Type</b>: Historic Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#historic)</span></p><p><b>Evidence Status</b>: Closed Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#closed-gap)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-04-01</p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 227: Pulmonary Fibrosis and Other Chronic Lung Disorders <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#227 "Pulmonary Fibrosis and Other Chronic Lung Disorders")</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-002</blockquote><p><b>Risk Adjustment Suspect Type</b>: Historic Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#historic)</span></p><p><b>Evidence Status</b>: Open Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#open-gap)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2020-07-01</p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 131: Bipolar Disorders <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#131 "Bipolar Disorders")</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-003</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</b>: Closed Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#closed-gap)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-02-15</p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 30: Diabetes with Chronic Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#30 "Diabetes with Chronic Complications")</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-004</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-04-01</p><p><b>Evidence Status</b>: Closed Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 43: Morbid Obesity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#43 "Morbid Obesity")</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-005</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</b>: Pending Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#pending)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-29</p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 31: Diabetes without Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#31 "Diabetes without Complications")</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-006</blockquote><p><b>Risk Adjustment Suspect Type</b>: Net-New Condition Category <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type CodeSystem</a>#net-new)</span></p><p><b>Evidence Status</b>: Pending Condition Category Gap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-evidence-status.html">Risk Adjustment Evidence Status CodeSystem</a>#pending)</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-29</p><p><b>Hierarchical Status</b>: Hierarchies not applied <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status CodeSystem</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#226 "Chronic Obstructive Pulmonary Disease and Asthma")</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href="Condition-ra-condition09pat01.html">Condition/ra-condition09pat01</a></li><li><a href="Condition-ra-condition08pat01.html">Condition/ra-condition08pat01</a></li><li><a href="Condition-ra-condition02pat01.html">Condition/ra-condition02pat01</a></li><li><a href="Condition-ra-condition17pat01.html">Condition/ra-condition17pat01</a></li><li><a href="Condition-ra-condition10pat01.html">Condition/ra-condition10pat01</a></li><li><a href="Condition-ra-condition03pat01.html">Condition/ra-condition03pat01</a></li><li><a href="Condition-ra-condition44pat01.html">Condition/ra-condition44pat01</a></li><li><a href="Encounter-ra-encounter09pat01.html">Encounter/ra-encounter09pat01</a></li><li><a href="Encounter-ra-encounter08pat01.html">Encounter/ra-encounter08pat01</a></li><li><a href="Encounter-ra-encounter02pat01.html">Encounter/ra-encounter02pat01</a></li><li><a href="Encounter-ra-encounter03pat01.html">Encounter/ra-encounter03pat01</a></li><li><a href="Encounter-ra-encounter45pat01.html">Encounter/ra-encounter45pat01</a></li></ul></div>
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<type value="individual"/>
<measure
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<subject>
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<date value="2021-10-18"/>
<reporter>
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<end value="2021-09-30"/>
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<code value="227"/>
<display value="Pulmonary Fibrosis and Other Chronic Lung Disorders"/>
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<text
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<group id="group-002">
<extension
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<valueDate value="2020-07-01"/>
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<text value="CMS-RxHCC 131: Bipolar Disorders"/>
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<extension
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<extension
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<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
<version value="5"/>
<code value="30"/>
<display value="Diabetes with Chronic Complications"/>
</coding>
<text value="CMS-RxHCC 30: Diabetes with Chronic Complications"/>
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<coding>
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<code>
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<version value="5"/>
<code value="43"/>
<display value="Morbid Obesity"/>
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<text value="CMS-RxHCC 43: Morbid Obesity"/>
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<group id="group-005">
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<extension
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<coding>
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<code value="pending"/>
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<extension
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<valueDate value="2021-09-29"/>
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<extension
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<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
<version value="5"/>
<code value="31"/>
<display value="Diabetes without Complications"/>
</coding>
<text value="CMS-RxHCC 31: Diabetes without Complications"/>
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</group>
<group id="group-006">
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<code value="net-new"/>
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<valueCodeableConcept>
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<coding>
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<code value="not-applied"/>
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</valueCodeableConcept>
</extension>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
<version value="5"/>
<code value="226"/>
<display value="Chronic Obstructive Pulmonary Disease and Asthma"/>
</coding>
<text
value="CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma"/>
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<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-001"/>
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<reference value="Condition/ra-condition09pat01"/>
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<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-002"/>
</extension>
<reference value="Condition/ra-condition08pat01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-003"/>
</extension>
<reference value="Condition/ra-condition02pat01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-004"/>
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<reference value="Condition/ra-condition17pat01"/>
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<evaluatedResource>
<extension
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<valueString value="group-005"/>
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<reference value="Condition/ra-condition10pat01"/>
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<evaluatedResource>
<extension
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<valueString value="group-006"/>
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<reference value="Condition/ra-condition03pat01"/>
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<evaluatedResource>
<extension
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<valueString value="group-001"/>
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<reference value="Condition/ra-condition44pat01"/>
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<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-001"/>
</extension>
<reference value="Encounter/ra-encounter09pat01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-002"/>
</extension>
<reference value="Encounter/ra-encounter08pat01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-003"/>
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<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-004"/>
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<reference value="Encounter/ra-encounter02pat01"/>
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<evaluatedResource>
<extension
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<valueString value="group-005"/>
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<extension
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<valueString value="group-006"/>
</extension>
<reference value="Encounter/ra-encounter03pat01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
<valueString value="group-001"/>
</extension>
<reference value="Encounter/ra-encounter45pat01"/>
</evaluatedResource>
</MeasureReport>
IG © 2021+ HL7 Clinical Quality Information Work Group. Package hl7.fhir.us.davinci-ra#2.0.0-ballot based on FHIR 4.0.1. Generated 2023-03-28
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