Da Vinci Risk Adjustment Implementation Guide
1.0.0 - STU 1 US

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Risk Adjustment Suspect Type Code System - JSON Representation

Active as of 2022-06-16

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{
  "resourceType" : "CodeSystem",
  "id" : "suspect-type",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">historic<a name=\"suspect-type-historic\"> </a></td><td>Historic Condition Category Gap</td><td>Historic Condition Category (CC) Gap. Historic Condition Category (CC) is based on data from a prior clinical evaluation period.</td></tr><tr><td style=\"white-space:nowrap\">suspected<a name=\"suspect-type-suspected\"> </a></td><td>Suspected Condtion Category Gap</td><td>Suspected Condition Category (CC) Gap. A member never has Condition Category (CC) before, but when a Server runs a suspecting algorithm, suspected Condition Categories (CCs) are identified for the member.</td></tr><tr><td style=\"white-space:nowrap\">net-new<a name=\"suspect-type-net-new\"> </a></td><td>Net-New Condition Category</td><td>Net-New Condition Category (CC). New Condition Category (CC), not from suspected process or historic. A Net-New Condition Category (CC) is documented for the first time during the clinical evaluation period for the\n      risk adjustment model. Any Condition Categories (CCs) that are net new must be either closed-gap or pending, and can not be open-gap.</td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type",
  "version" : "1.0.0",
  "name" : "RiskAdjustmentSuspectTypeCodeSystem",
  "title" : "Risk Adjustment Suspect Type Code System",
  "status" : "active",
  "date" : "2022-06-16T14:23:36+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 code system for Risk Adjustment suspect type to indicate whether it is a suspected Condition Category (CC) gap,\n  a historic Condition Category (CC) gap, or an unsuspected Condition Category (CC). Historic, suspected, and net-new are mutually exclusive.",
  "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",
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 3,
  "concept" : [
    {
      "code" : "historic",
      "display" : "Historic Condition Category Gap",
      "definition" : "Historic Condition Category (CC) Gap. Historic Condition Category (CC) is based on data from a prior clinical evaluation period."
    },
    {
      "code" : "suspected",
      "display" : "Suspected Condtion Category Gap",
      "definition" : "Suspected Condition Category (CC) Gap. A member never has Condition Category (CC) before, but when a Server runs a suspecting algorithm, suspected Condition Categories (CCs) are identified for the member."
    },
    {
      "code" : "net-new",
      "display" : "Net-New Condition Category",
      "definition" : "Net-New Condition Category (CC). New Condition Category (CC), not from suspected process or historic. A Net-New Condition Category (CC) is documented for the first time during the clinical evaluation period for the\n      risk adjustment model. Any Condition Categories (CCs) that are net new must be either closed-gap or pending, and can not be open-gap."
    }
  ]
}