Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each MeasureReport must have:

1. A MeasureReport.status element
2. A MeasureReport.type element hard coded to “individual”
3. A MeasureReport.measure element references a Risk Adjustment model measure
4. A MeasureReport.subject element references a US Core Patient profile
5. A MeasureReport.period element for the clinical evaluation period for which the risk adjustment coding gap report was generated.

Each MeasureReport should have ([Must Support]):

1. Zero to many MeasureReport.group element
2. Each MeasureReport.group should have a MeasureReport.group.code element
3. Each MeasureReport.group should have a MeasureReport.group.ra-suspectType element
4. Each MeasureReport.group should have a MeasureReport.group.ra-evidenceStatus element
5. Each MeasureReport.group should have a MeasureReport.group.ra-evidenceStatusDate element
6. Each MeasureReport.group should have a MeasureReport.group.ra-hierarchicalStatus element
7. Each MeasureReport.group should have zero to many MeasureReport.evalautedResource element

Additional Profile specific implementation guidance:

1. evaluatedResource SHALL reference resources using USCore profiles where applicable
2. All resources referenced by evaluatedResource SHALL be returned in the bundle by $report operation

The Clinical Data Collection Deadline element, ra-clinicalDataCollectionDeadline, was added as an extension to MeasureReport. We are seeking comment from implementers if they intend to use this element when communicating risk adjustment coding gap reports from payers to providers.

• Text Summary
• Differential Table
• Snapshot Table
• Snapshot Table (Must Support)
• All

This structure is derived from MeasureReport

Name	Flags	Card.	Type	Description & Constraints
MeasureReport		0..*	MeasureReport	This is a Risk Adjustment Coding Gap Report.
ra-clinicalDataCollectionDeadline	S	0..1	date	This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
status	S	1..1	code	complete | pending | error
type	S	1..1	code	The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Fixed Value: individual
measure	S	1..1	canonical(Risk Adjustment Model Measure)	This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.
subject	S	1..1	Reference(US Core Patient Profile)	What individual(s) the report is for
date	S	1..1	dateTime	When the report was generated
reporter	S	1..1	Reference(US Core Organization Profile)	Organization that generated the MeasureReport
period	SI	1..1	Period	Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	1..1	dateTime	End time with inclusive boundary, if not ongoing
group	S	0..*	BackboneElement	A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id	S	1..1	string	Unique id for inter-element referencing
ra-suspectType	S	0..1	CodeableConcept	This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type Value Set (extensible)
ra-evidenceStatus	S	0..1	CodeableConcept	This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status Value Set (extensible)
ra-evidenceStatusDate	S	0..1	date	When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
ra-hierarchicalStatus	S	0..1	CodeableConcept	This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status Value Set (extensible)
code	S	0..1	CodeableConcept	Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example)
stratifier
code		0..1	CodeableConcept	What stratifier of the group
evaluatedResource	S	0..*	Reference(Resource)	An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
ra-groupReference	S	0..*	string	This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MeasureReport	I	0..*	MeasureReport	This is a Risk Adjustment Coding Gap Report.
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
ra-clinicalDataCollectionDeadline	S	0..1	date	This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Additional identifier for the MeasureReport
status	?!SΣ	1..1	code	complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type	SΣI	1..1	code	The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure	SΣ	1..1	canonical(Risk Adjustment Model Measure)	This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.
subject	SΣ	1..1	Reference(US Core Patient Profile)	What individual(s) the report is for
date	SΣ	1..1	dateTime	When the report was generated
reporter	SΣ	1..1	Reference(US Core Organization Profile)	Organization that generated the MeasureReport
period	SΣI	1..1	Period	Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣI	1..1	dateTime	Starting time with inclusive boundary
end	SΣI	1..1	dateTime	End time with inclusive boundary, if not ongoing
improvementNotation	?!Σ	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group	SI	0..*	BackboneElement	A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id	S	1..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ra-suspectType	S	0..1	CodeableConcept	This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type Value Set (extensible)
ra-evidenceStatus	S	0..1	CodeableConcept	This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status Value Set (extensible)
ra-evidenceStatusDate	S	0..1	date	When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
ra-hierarchicalStatus	S	0..1	CodeableConcept	This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status Value Set (extensible)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	0..1	CodeableConcept	Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example)
population		0..*	BackboneElement	The populations in the group
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count		0..1	integer	Size of the population
subjectResults		0..1	Reference(List)	For subject-list reports, the subject results in this population
measureScore	Σ	0..1	Quantity	What score this group achieved
stratifier		0..*	BackboneElement	Stratification results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	What stratifier of the group
stratum		0..*	BackboneElement	Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value		0..1	CodeableConcept	The stratum value, e.g. male
component		0..*	BackboneElement	Stratifier component values
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	What stratifier component of the group
value		1..1	CodeableConcept	The stratum component value, e.g. male
population		0..*	BackboneElement	Population results in this stratum
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count		0..1	integer	Size of the population
subjectResults		0..1	Reference(List)	For subject-list reports, the subject results in this population
measureScore		0..1	Quantity	What score this stratum achieved
evaluatedResource	S	0..*	Reference(Resource)	An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
ra-groupReference	S	0..*	string	This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
reference	ΣI	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MeasureReport	I	0..*	MeasureReport	This is a Risk Adjustment Coding Gap Report.
ra-clinicalDataCollectionDeadline		0..1	date	This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
status	?!Σ	1..1	code	complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type	ΣI	1..1	code	The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure	Σ	1..1	canonical(Risk Adjustment Model Measure)	This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.
subject	Σ	1..1	Reference(US Core Patient Profile)	What individual(s) the report is for
date	Σ	1..1	dateTime	When the report was generated
reporter	Σ	1..1	Reference(US Core Organization Profile)	Organization that generated the MeasureReport
period	ΣI	1..1	Period	Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start	ΣI	1..1	dateTime	Starting time with inclusive boundary
end	ΣI	1..1	dateTime	End time with inclusive boundary, if not ongoing
group	I	0..*	BackboneElement	A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id		1..1	string	Unique id for inter-element referencing
ra-suspectType		0..1	CodeableConcept	This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type Value Set (extensible)
ra-evidenceStatus		0..1	CodeableConcept	This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status Value Set (extensible)
ra-evidenceStatusDate		0..1	date	When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
ra-hierarchicalStatus		0..1	CodeableConcept	This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status Value Set (extensible)
code	Σ	0..1	CodeableConcept	Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example)
evaluatedResource		0..*	Reference(Resource)	An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
ra-groupReference		0..*	string	This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

This structure is derived from MeasureReport

Summary

Mandatory: 6 elements (1 nested mandatory element)
Must-Support: 19 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

• Risk Adjustment Model Measure (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-model-measure)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType
• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus
• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus
• http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference

Differential View

This structure is derived from MeasureReport

Name	Flags	Card.	Type	Description & Constraints
MeasureReport		0..*	MeasureReport	This is a Risk Adjustment Coding Gap Report.
ra-clinicalDataCollectionDeadline	S	0..1	date	This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
status	S	1..1	code	complete | pending | error
type	S	1..1	code	The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Fixed Value: individual
measure	S	1..1	canonical(Risk Adjustment Model Measure)	This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.
subject	S	1..1	Reference(US Core Patient Profile)	What individual(s) the report is for
date	S	1..1	dateTime	When the report was generated
reporter	S	1..1	Reference(US Core Organization Profile)	Organization that generated the MeasureReport
period	SI	1..1	Period	Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	1..1	dateTime	End time with inclusive boundary, if not ongoing
group	S	0..*	BackboneElement	A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id	S	1..1	string	Unique id for inter-element referencing
ra-suspectType	S	0..1	CodeableConcept	This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type Value Set (extensible)
ra-evidenceStatus	S	0..1	CodeableConcept	This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status Value Set (extensible)
ra-evidenceStatusDate	S	0..1	date	When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
ra-hierarchicalStatus	S	0..1	CodeableConcept	This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status Value Set (extensible)
code	S	0..1	CodeableConcept	Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example)
stratifier
code		0..1	CodeableConcept	What stratifier of the group
evaluatedResource	S	0..*	Reference(Resource)	An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
ra-groupReference	S	0..*	string	This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MeasureReport	I	0..*	MeasureReport	This is a Risk Adjustment Coding Gap Report.
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
ra-clinicalDataCollectionDeadline	S	0..1	date	This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Additional identifier for the MeasureReport
status	?!SΣ	1..1	code	complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type	SΣI	1..1	code	The type code is fixed to 'individual' for Risk Adjustment Coding Gap Report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure	SΣ	1..1	canonical(Risk Adjustment Model Measure)	This references a measure that represents a Risk Adjustment model, such as CMS-HCC V24.
subject	SΣ	1..1	Reference(US Core Patient Profile)	What individual(s) the report is for
date	SΣ	1..1	dateTime	When the report was generated
reporter	SΣ	1..1	Reference(US Core Organization Profile)	Organization that generated the MeasureReport
period	SΣI	1..1	Period	Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣI	1..1	dateTime	Starting time with inclusive boundary
end	SΣI	1..1	dateTime	End time with inclusive boundary, if not ongoing
improvementNotation	?!Σ	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group	SI	0..*	BackboneElement	A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id	S	1..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ra-suspectType	S	0..1	CodeableConcept	This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type Value Set (extensible)
ra-evidenceStatus	S	0..1	CodeableConcept	This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status Value Set (extensible)
ra-evidenceStatusDate	S	0..1	date	When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
ra-hierarchicalStatus	S	0..1	CodeableConcept	This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status Value Set (extensible)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	0..1	CodeableConcept	Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example)
population		0..*	BackboneElement	The populations in the group
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count		0..1	integer	Size of the population
subjectResults		0..1	Reference(List)	For subject-list reports, the subject results in this population
measureScore	Σ	0..1	Quantity	What score this group achieved
stratifier		0..*	BackboneElement	Stratification results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	What stratifier of the group
stratum		0..*	BackboneElement	Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value		0..1	CodeableConcept	The stratum value, e.g. male
component		0..*	BackboneElement	Stratifier component values
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	What stratifier component of the group
value		1..1	CodeableConcept	The stratum component value, e.g. male
population		0..*	BackboneElement	Population results in this stratum
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count		0..1	integer	Size of the population
subjectResults		0..1	Reference(List)	For subject-list reports, the subject results in this population
measureScore		0..1	Quantity	What score this stratum achieved
evaluatedResource	S	0..*	Reference(Resource)	An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
ra-groupReference	S	0..*	string	This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
reference	ΣI	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Documentation for this format