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 - XML Representation

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="suspect-type"/>
  <text>
    <status value="generated"/>
    <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
      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>
  </text>
  <url value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
  <version value="0.1.0"/>
  <name value="RiskAdjustmentSuspectTypeCodeSystem"/>
  <title value="Risk Adjustment Suspect Type Code System"/>
  <status value="draft"/>
  <date value="2021-12-06T22:33:15+00:00"/>
  <publisher value="HL7 Clinical Quality Information Work Group"/>
  <contact>
    <name value="HL7 Clinical Quality Information Work Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="This is a code system for Risk Adjustment suspect type to indicate whether it is a suspected Condition Category (CC) gap,
  a historic CC gap, or an unsuspected CC. Historic, suspected, and net-new are mutually exclusive."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License"/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="3"/>
  <concept>
    <code value="historic"/>
    <display value="Historic Condition Category Gap"/>
    <definition
                value="Historic Condition Category (CC) Gap. Historic CC is based on data from a prior clinical evaluation period."/>
  </concept>
  <concept>
    <code value="suspected"/>
    <display value="Suspected Condtion Category Gap"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="net-new"/>
    <display value="Net-New Condition Category"/>
    <definition
                value="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
      risk adjustment model. Any CCs that are net new must be either closed-gap or pending, and can not be open-gap."/>
  </concept>
</CodeSystem>