Left: | Risk Adjustment Coding Gap Report Profile (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport) |
Right: | Risk Adjustment Coding Gap Report Profile (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport) |
Error | StructureDefinition.version | Values for version differ: '0.1.0' vs '1.0.0' |
Information | StructureDefinition.date | Values for date differ: '2021-11-11' vs '2022-06-16T14:23:36+00:00' |
Warning | MeasureReport.extension | Elements differ in short: '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.' vs '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.' |
Error | MeasureReport.extension | Type Mismatch: Extension([CanonicalType[http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline]]) vs Extension([CanonicalType[http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline]]) |
Error | MeasureReport.measure | Type Mismatch: canonical([CanonicalType[http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-model-measure]]) vs canonical([CanonicalType[http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-model-measure]]) |
Information | MeasureReport.improvementNotation | Element maximum cardinalities differ: '0' vs '1' |
Warning | MeasureReport.group.code | Elements differ in short: 'Condition Categories code such as Hierarchical Condition Categories (HCC) code 19.' vs 'Condition Category (CC) code for a Risk Adjustment Model' |
Warning | MeasureReport.group.code | Elements differ in definition: 'Condition Categories code such as Hierarchical Condition Categories (HCC) code 19.' vs 'Condition Category (CC) code for a Risk Adjustment Model.' |
Information | MeasureReport.group.population | Element maximum cardinalities differ: '0' vs '2147483647' |
Information | MeasureReport.group.measureScore | Element maximum cardinalities differ: '0' vs '1' |
Information | MeasureReport.group.stratifier | Element maximum cardinalities differ: '0' vs '2147483647' |
Information | MeasureReport.group.stratifier.code | Element maximum cardinalities differ: '2147483647' vs '1' |
Warning | MeasureReport.evaluatedResource | Elements differ in short: 'Supporting evidence for Condition Categories coding gaps, such as encounter, medication, and lab. An evidence is linked to a specific Condition Category through referencing the MeasureReport.group.id.' vs '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.' |
Warning | MeasureReport.evaluatedResource | Elements differ in definition: 'Supporting evidence for Condition Categories coding gaps, such as encounter, medication, and lab.' vs '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 an Condition Category (CC) gap.' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/MeasureReport | ||
copyright | Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License | ||
date | 2021-11-11 | 2022-06-16T14:23:36+00:00 |
|
description | This risk adjustment coding gap report profile is based on the [MeasureReport](http://hl7.org/fhir/R4/measurereport.html) to represent a risk adjustment coding gap report. | ||
experimental | false | ||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | RiskAdjustmentCodingGapReport | ||
publisher | HL7 Clinical Quality Information Work Group | ||
purpose | |||
status | active | ||
title | Risk Adjustment Coding Gap Report Profile | ||
type | MeasureReport | ||
url | http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport | ||
version | 0.1.0 | 1.0.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
MeasureReport | I | 0..* | MeasureReport | This is a Risk Adjustment Coding Gap Report. | I | 0..* | MeasureReport | This is a Risk Adjustment Coding Gap Report. | |||||||||
id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | string | Logical id of this artifact | |||||||||
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!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.
| 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | 0..* | Resource | Contained, inline Resources | 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. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/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 | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport | 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. | ?!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 | 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. | 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 | 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 | SΣ | 1..1 | dateTime | When the report was generated | |||||||||
reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 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 | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
reference | ΣI | 0..1 | string | Literal reference, Relative, internal or absolute URL | 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). | 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 | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||
display | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
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 ) | 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 | 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 | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
start | SΣI | 1..1 | dateTime | Starting time with inclusive boundary | SΣI | 1..1 | dateTime | Starting time with inclusive boundary | |||||||||
end | SΣI | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | SΣI | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | |||||||||
improvementNotation | ?!Σ | 0..0 | ?!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. | 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 | S | 1..1 | string | Unique id for inter-element referencing | |||||||||
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
code | SΣ | 0..1 | CodeableConcept | Condition Categories code such as Hierarchical Condition Categories (HCC) code 19. | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Example CMS Hierarchical Condition Category Value Set (example) |
| ||||||||
population | 0..0 | 0..* | BackboneElement | The populations in the group |
| ||||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!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.). | 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 | 0..1 | integer | Size of the population | |||||||||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||||||||
measureScore | Σ | 0..0 | Σ | 0..1 | Quantity | What score this group achieved |
| ||||||||||
stratifier | 0..0 | 0..* | BackboneElement | Stratification results |
| ||||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
code | 0..* | CodeableConcept | What stratifier of the group | 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 | 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 | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
value | 0..1 | CodeableConcept | The stratum value, e.g. male | 0..1 | CodeableConcept | The stratum value, e.g. male | |||||||||||
component | 0..* | BackboneElement | Stratifier component values | 0..* | BackboneElement | Stratifier component values | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
code | 1..1 | CodeableConcept | What stratifier component of the group | 1..1 | CodeableConcept | What stratifier component of the group | |||||||||||
value | 1..1 | CodeableConcept | The stratum component value, e.g. male | 1..1 | CodeableConcept | The stratum component value, e.g. male | |||||||||||
population | 0..* | BackboneElement | Population results in this stratum | 0..* | BackboneElement | Population results in this stratum | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!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.). | 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 | 0..1 | integer | Size of the population | |||||||||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||||||||
measureScore | 0..1 | Quantity | What score this stratum achieved | 0..1 | Quantity | What score this stratum achieved | |||||||||||
evaluatedResource | S | 0..* | Reference(Resource) | Supporting evidence for Condition Categories coding gaps, such as encounter, medication, and lab. An evidence is linked to a specific Condition Category through referencing the MeasureReport.group.id. | 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 | 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 | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
reference | ΣI | 0..1 | string | Literal reference, Relative, internal or absolute URL | 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). | 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 | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||
display | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
Documentation for this format |