Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Extension: Condition Category Remark Extension

Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark Version: 2.1.0
Standards status: Trial-use Maturity Level: 2 Computable Name: ConditionCategoryRemark
Other Identifiers: OID:2.16.840.1.113883.4.642.40.29.42.1

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

Context of Use

This extension may be used on the following element(s):

  • Element ID MeasureReport.group

Usage info

Usages:

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Complex Extension: The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

  • author: Identifier, string: An Extension
  • authorOrganization: Identifier, string, Reference: An Extension
  • authorSoftware: Identifier, string: An Extension
  • authorDatetime: dateTime: An Extension
  • text: string: An Extension
  • code: CodeableConcept: An Extension
  • reasonCode: CodeableConcept: An Extension
  • relatedData: Identifier, Reference: An Extension
  • qualifyingDxCode: CodeableConcept: Diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. A string data type is supported
  • qualifyingDxList: string: A text list of diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available.

Maturity: 2

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... Slices for extension Content/Rules for all slices
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
... value[x] 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... 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
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The Condition Category Remark extension allows a coded and/or narrative remark be added to a Condition Category (CC) coding gap that is on a Payer generated risk adjustment coding gap report by a provider, an organization, or a software.

  • author: Identifier, string: An Extension
  • authorOrganization: Identifier, string, Reference: An Extension
  • authorSoftware: Identifier, string: An Extension
  • authorDatetime: dateTime: An Extension
  • text: string: An Extension
  • code: CodeableConcept: An Extension
  • reasonCode: CodeableConcept: An Extension
  • relatedData: Identifier, Reference: An Extension
  • qualifyingDxCode: CodeableConcept: Diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. A string data type is supported
  • qualifyingDxList: string: A text list of diagnosis codes (e.g., ICD-10) for conditions that are classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available.

Maturity: 2

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... Slices for extension Content/Rules for all slices
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
... value[x] 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension C 0..* Extension Condition Category remark
Constraints: ra-2
... 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
.... extension:author 0..1 Extension Identifier of the person who added the remark such as NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "author"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorOrganization 0..1 Extension Identifier of the organization that added the remark such as TIN, NPI
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorOrganization"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
...... valueReference Reference(US Core Organization Profile(7.0.0))
.... extension:authorSoftware 0..1 Extension Identifier of the software that added the remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorSoftware"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueString string
.... extension:authorDatetime 0..1 Extension When the remark was added
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorDatetime"
..... value[x] 1..1 dateTime Value of extension
.... extension:text 0..* Extension Free text remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "text"
..... value[x] 1..1 string Value of extension
.... extension:code 0..1 Extension Coded remark
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "code"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Coding Gap Remark (extensible)
.... extension:reasonCode 0..* Extension Remark reason
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "reasonCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: Remark Reason (extensible)
.... extension:relatedData 0..* Extension Related data
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "relatedData"
..... value[x] 1..1 Value of extension
...... valueIdentifier Identifier
...... valueReference Reference(Any)
.... extension:qualifyingDxCode 0..* Extension Diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxCode"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: USCoreConditionCodes (7.0.0) (preferred)
.... extension:qualifyingDxList 0..* Extension A list of diagnosis codes classified under a Condition Category as defined by the risk adjustment model
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1 uri "qualifyingDxList"
..... value[x] 1..1 string Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:code.value[x]extensibleCodingGapRemark(a valid code from Coding Gap Remark Codes)
http://hl7.org/fhir/us/davinci-ra/ValueSet/coding-gap-remark
From this IG
Extension.extension:reasonCode.value[x]extensibleRemarkReason(a valid code from Remark Reason Codes)
http://hl7.org/fhir/us/davinci-ra/ValueSet/remark-reason
From this IG
Extension.extension:qualifyingDxCode.value[x]preferredUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ra-2errorExtensionA remark shall include an author, an authorOrganization, or an authorSoftware
: extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()