CodeSystem-suspect-type

Source

hl7.fhir.us.davinci-ra#current:Da Vinci Risk Adjustment Implementation Guide (v4.0.1)

resourceType

CodeSystem

suspect-type

canonical

http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type

version

2.0.0-ballot

status

active

publisher

HL7 Clinical Quality Information Work Group

name

RiskAdjustmentSuspectType

title

Risk Adjustment Suspect Type CodeSystem

date

2023-06-05T00:54:54+00:00

experimental

false

description

Risk Adjustment suspect type indicates whether it is a suspected Condition Category (CC) gap, a historic Condition Category (CC) gap, or an unsuspected Condition Category (CC). Historic, suspected, and net-new are mutually exclusive.

jurisdictions

caseSensitive

true

valueSet

http://hl7.org/fhir/us/davinci-ra/ValueSet/suspect-type

content

complete

Usages

Risk Adjustment Suspect Type ValueSet (system)

This case-sensitive code system http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type defines the following codes:

Code	Display	Definition
historic	Historic Condition Category Gap	Historic Condition Category (CC) Gap. Historic Condition Category (CC) is based on data from a prior clinical evaluation period.
suspected	Suspected Condition Category Gap	Suspected Condition Category (CC) Gap. A member never has Condition Category (CC) before, but when a Server runs a suspecting algorithm, suspected Condition Categories (CCs) are identified for the member.
net-new	Net-New Condition Category	Net-New Condition Category (CC). New Condition Category (CC), not from suspected process or historic. A Net-New Condition Category (CC) is documented for the first time during the clinical evaluation period for the risk adjustment model. Any Condition Categories (CCs) that are net new must be either closed-gap or pending, and can not be open-gap.

Produced 08 Sep 2023