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

Publication Build: This will be filled in by the publication tooling

## Example MeasureReport: ra-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03

Generated Narrative: MeasureReport

Resource MeasureReport "ra-measurereport05"

Profile: Risk Adjustment Coding Gap MeasureReport

Risk Adjustment Clinical Data Collection Deadline: 2022-03-31

status: complete

type: individual

measure: Risk Adjustment Model Version 5 - CMS Prescribing Drug Hierarchical Category Condition (CMS-HCC)

subject: Patient/ra-patient03 " NUCLEAR"

date: 2021-10-18

reporter: Organization/ra-payer01 "ABC Payer"

period: 2021-01-01 --> 2021-09-30

> group

> > id

> > group-001

> Risk Adjustment Suspect Type: Historic Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#historic)

> Evidence Status: Pending Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#pending)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma (CMS Prescription Drug Hierarchical Condition Categories[5]#226 "Chronic Obstructive Pulmonary Disease and Asthma")

> group

> > id

> > group-002

> Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

> Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 31: Diabetes without Complication (CMS Prescription Drug Hierarchical Condition Categories[5]#31 "Diabetes without Complication")

> group

> > id

> > group-003

> Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

> Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 30: Diabetes with Complications (CMS Prescription Drug Hierarchical Condition Categories[5]#30 "Diabetes with Complications")

> group

> > id

> > group-004

> Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

> Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 261: Dialysis Status (CMS Prescription Drug Hierarchical Condition Categories[5]#261 "Dialysis Status")

> group

> > id

> > group-005

> Risk Adjustment Suspect Type: Suspected Condition Category Gap (Risk Adjustment Suspect Type CodeSystem#suspected)

> Evidence Status: Open Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#open-gap)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 262: Chronic Kidney Disease Stage 5 (CMS Prescription Drug Hierarchical Condition Categories[5]#262 "Chronic Kidney Disease Stage 5")

> group

> > id

> > group-006

> Risk Adjustment Suspect Type: Net-New Condition Category (Risk Adjustment Suspect Type CodeSystem#net-new)

> Evidence Status: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

> Hierarchical Status: Hierarchies not applied (Risk Adjustment Hierarchical Status CodeSystem#not-applied)

> code: CMS-RxHCC 216: Peripheral Vascular Disease (CMS Prescription Drug Hierarchical Condition Categories[5]#216 "Peripheral Vascular Disease")

evaluatedResource:

- Condition/ra-condition04pat03
- Condition/ra-condition21pat03
- Condition/ra-condition15pat03
- Condition/ra-condition16pat03
- Condition/ra-condition35pat03
- Encounter/ra-encounter04pat03
- Encounter/ra-encounter21pat03
- Encounter/ra-encounter15pat03
- Encounter/ra-encounter16pat03
- Encounter/ra-encounter35pat03
- Observation/ra-obs01pat03