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

: Sample CMS Hierarchical Condition Category - JSON Representation

Active as of 2023-03-28

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{
  "resourceType" : "ValueSet",
  "id" : "sample-cmshcc",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-cmshcc.html\"><code>http://terminology.hl7.org/CodeSystem/cmshcc</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td>22</td><td>Morbid Obesity</td></tr><tr><td>88</td><td>Angina Pectoris</td></tr><tr><td>112</td><td>Fibrosis of Lung and Other Chronic Lung Disorders</td></tr></table></li></ul></div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc",
  "version" : "2.0.0-ballot",
  "name" : "SampleCMSHCC",
  "title" : "Sample CMS Hierarchical Condition Category",
  "status" : "active",
  "experimental" : false,
  "date" : "2023-03-28T02:02:49+00:00",
  "publisher" : "HL7 Clinical Quality Information Work Group",
  "contact" : [
    {
      "name" : "HL7 Clinical Quality Information Work Group",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "This is a sample of the concepts that can be found in the CMS Hierarchical Condition Categories (CMS-HCC) code system version 24. The source of the codes included in this example was published at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories (CCs) that predict costs well. The condition categories (CCs) are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the Condition Categories (CCs) to capture the most costly diagnoses. Hierarchy logic is imposed on certain Condition Categories (CCs) to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
        "concept" : [
          {
            "code" : "22",
            "display" : "Morbid Obesity"
          },
          {
            "code" : "88",
            "display" : "Angina Pectoris"
          },
          {
            "code" : "112",
            "display" : "Fibrosis of Lung and Other Chronic Lung Disorders"
          }
        ]
      }
    ]
  }
}