| Name | Flags | Card. | Type |
Description & Constraints
|
|---|---|---|---|---|
MeasureReport
|
MeasureReport | This is a risk adjustment coding gap report. | ||
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 |
status
|
S | |||
type
|
S | code |
The type code is fixed to 'individual' for a risk adjustment coding gap report Fixed Value: individual |
|
|
measure
|
S | canonical (Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24. | |
subject
|
S | 1..1 | Reference (US Core Patient Profile) | |
|
date
|
S | 1..1 | When the report was generated | |
|
reporter
|
S | 1..1 | Reference (US Core Organization Profile) | Organization that generated the MeasureReport |
period
|
S C | 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 ) |
start
|
S | 1..1 | ||
end
|
S | 1..1 | ||
|
group
|
S | 0..* |
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 | ||
|
suspectType
|
S | 0..1 | CodeableConcept |
This is the risk adjustment suspect type for a Condition Category (CC) gap
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet ( extensible ) |
|
evidenceStatus
|
S | 0..1 | CodeableConcept |
This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending.
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet ( extensible ) |
|
evidenceStatusDate
|
S | 0..1 | date |
When the evidence status was changed to either closed-gap, open-gap, or pending
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate |
|
hierarchicalStatus
|
S | 0..1 | CodeableConcept |
This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet ( extensible ) |
|
confidenceScale
|
S | 0..1 | CodeableConcept |
Confidence scale for a coding gap
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set ( extensible ) |
|
annotation
|
S | 0..* | (Complex) |
Annotation
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation |
|
code
|
S | 0..1 | CodeableConcept |
Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category ( example ) |
|
stratifier
|
||||
code
|
0..1 | |||
|
evaluatedResource
|
S | 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. | ||
|
groupReference
|
S | 0..* | string |
This references the MeasureReport.group.id.
URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference |
|
Documentation for this format
|
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