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-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03

Generated Narrative: MeasureReport

Resource MeasureReport "ra-measurereport04"

Profile: Risk Adjustment Coding Gap MeasureReport

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

status: complete

type: individual

measure: Risk Adjustment Model Version 21 - CMS 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: Closed Condition Category Gap (Risk Adjustment Evidence Status CodeSystem#closed-gap)

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 188: Artificial Openings for Feeding or Elimination (CMS Hierarchical Condition Categories[21]#188 "Artificial Openings for Feeding or Elimination")

> group

> > id

> > group-002

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 111: Chronic Obstructive Pulmonary Disease (CMS Hierarchical Condition Categories[21]#111 "Chronic Obstructive Pulmonary Disease")

> group

> > id

> > group-003

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 21: Protein-Calorie Malnutrition (CMS Hierarchical Condition Categories[21]#21 "Protein-Calorie Malnutrition")

> group

> > id

> > group-004

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 35: Inflammatory Bowel Disease (CMS Hierarchical Condition Categories[21]#35 "Inflammatory Bowel Disease")

> group

> > id

> > group-005

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 96: Specified Heart Arrhythmia (CMS Hierarchical Condition Categories[21]#96 "Specified Heart Arrhythmias")

> group

> > id

> > group-006

> 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 applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 18: Diabetes with Chronic Complications (CMS Hierarchical Condition Categories[21]#18 "Diabetes with Chronic Complications")

> group

> > id

> > group-007

> 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 applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 134: Dialysis Status (CMS Hierarchical Condition Categories[21]#134 "Dialysis Status")

> group

> > id

> > group-008

> 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 applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 58: Major Depressive, Bipolar, and Paranoid Disorders (CMS Hierarchical Condition Categories[21]#58 "Major Depressive, Bipolar, and Paranoid Disorders")

> group

> > id

> > group-009

> 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 applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

> code: CMS-HCC 19: Diabetes without Complication (CMS Hierarchical Condition Categories[21]#19 "Diabetes without Complication")

> group

> > id

> > group-010

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

> code: CMS-HCC 135: Acute Renal Failure (CMS Hierarchical Condition Categories[21]#135 "Acute Renal Failure")

> group

> > id

> > group-011

> 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 applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

> code: CMS-HCC 136: Chronic Kidney Disease, Stage 5 (CMS Hierarchical Condition Categories[21]#136 "Chronic Kidney Disease, Stage 5")

> group

> > id

> > group-012

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

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

> Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: CMS-HCC 107: Vascular Disease with Complications (CMS Hierarchical Condition Categories[21]#107 "Vascular Disease with Complications")

> group

> > id

> > group-013

> 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 applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

> code: CMS-HCC 108: Vascular Disease (CMS Hierarchical Condition Categories[21]#108 "Vascular Disease")

evaluatedResource:

- Condition/ra-condition01pat03
- Condition/ra-condition04pat03
- Condition/ra-condition05pat03
- Condition/ra-condition06pat03
- Condition/ra-condition07pat03
- Condition/ra-condition15pat03
- Condition/ra-condition16pat03
- Condition/ra-condition21pat03
- Condition/ra-condition22pat03
- Condition/ra-condition32pat03
- Condition/ra-condition35pat03
- Condition/ra-condition42pat03
- Encounter/ra-encounter01pat03
- Encounter/ra-encounter04pat03
- Encounter/ra-encounter05pat03
- Encounter/ra-encounter06pat03
- Encounter/ra-encounter07pat03
- Encounter/ra-encounter15pat03
- Encounter/ra-encounter16pat03
- Encounter/ra-encounter19pat03
- Encounter/ra-encounter21pat03
- Encounter/ra-encounter22pat03
- Encounter/ra-encounter01pat03
- Encounter/ra-encounter35pat03
- Encounter/ra-encounter42pat03
- Observation/ra-obs01pat03
- Observation/ra-obs02pat03