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 - XML Representation

Active as of 2023-03-28

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="sample-cmshcc"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <url value="http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc"/>
  <version value="2.0.0-ballot"/>
  <name value="SampleCMSHCC"/>
  <title value="Sample CMS Hierarchical Condition Category"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2023-03-28T02:02:49+00:00"/>
  <publisher value="HL7 Clinical Quality Information Work Group"/>
  <contact>
    <name value="HL7 Clinical Quality Information Work Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License"/>
  <compose>
    <include>
      <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
      <concept>
        <code value="22"/>
        <display value="Morbid Obesity"/>
      </concept>
      <concept>
        <code value="88"/>
        <display value="Angina Pectoris"/>
      </concept>
      <concept>
        <code value="112"/>
        <display value="Fibrosis of Lung and Other Chronic Lung Disorders"/>
      </concept>
    </include>
  </compose>
</ValueSet>