Da Vinci Risk Adjustment Implementation Guide (STU1 Ballot)
0.1.0 - STU 1 Ballot

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v0.1.0: STU 1 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

: Risk Adjustment Suspect Type Code System - JSON Representation

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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 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 CC before, but when a Server runs a suspecting algorithm, suspected 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, not from suspected process or historic. A Net-New CC is documented for the first time during the clinical evaluation period for the\n      risk adjustment model. Any 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" : "0.1.0",
  "name" : "RiskAdjustmentSuspectTypeCodeSystem",
  "title" : "Risk Adjustment Suspect Type Code System",
  "status" : "draft",
  "date" : "2021-12-06T22:33:15+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 CC gap, or an unsuspected 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 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 CC before, but when a Server runs a suspecting algorithm, suspected CCs are identified for the member."
    },
    {
      "code" : "net-new",
      "display" : "Net-New Condition Category",
      "definition" : "Net-New Condition Category (CC). New Condition Category, not from suspected process or historic. A Net-New CC is documented for the first time during the clinical evaluation period for the\n      risk adjustment model. Any CCs that are net new must be either closed-gap or pending, and can not be open-gap."
    }
  ]
}