Da Vinci Risk Adjustment Implementation Guide
2.0.0-ballot - STU2 Ballot

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## CodeSystem: Risk Adjustment Suspect Type CodeSystem

Official URL: http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type | Version: 2.0.0-ballot
Active as of 2023-03-28 | Computable Name: RiskAdjustmentSuspectType
Copyright/Legal: Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License

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.

This Code system is referenced in the content logical definition of the following value sets:

- RiskAdjustmentSuspectType

This 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.