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-measurereport01-with-annotation: Risk Adjustment Measure Report with Annotation

Generated Narrative: MeasureReport

Resource MeasureReport "ra-measurereport01-with-annotation"

Profile: Risk Adjustment Coding Gap MeasureReport

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

status: complete

type: individual

measure: Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)

subject: Patient/ra-patient01 " EVERYWOMAN"

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)

> Risk Adjustment Evidence Status Date: 2021-04-01

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 Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: HCC 18: Diabetes with Chronic Complications (CMS Hierarchical Condition Categories[24]#18 "Diabetes with Chronic Complications")

> group

> > id

> > group-002

> 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)

> Risk Adjustment Evidence Status Date: 2021-09-29

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 Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> code: HCC 111: Chronic Obstructive Pulmonary Disease (CMS Hierarchical Condition Categories[24]#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)

> Risk Adjustment Evidence Status Date: 2020-07-15

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 Hierarchical Status: Hierarchies applied and Condition Category is not superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-not-superseded)

> > Annotation

> > > url

> > > `annotator`

> > value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

> > > url

> > > `annotated`

> > value: 2021-11-01

> > > url

> > > `text`

> > value: Diagnosis added

> > > url

> > > code

> > value: Assessed and present (Coding Gap Annotation CodeSystem#assessed-present)

> > > url

> > > `relatedData`

> > value: id: CLM23333

> code: HCC 59: Major Depressive, Bipolar, and Paranoid Disorders (CMS Hierarchical Condition Categories[24]#59 "Major Depressive, Bipolar, and Paranoid Disorders")

> group

> > id

> > group-004

> 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)

> Risk Adjustment Evidence Status Date: 2021-04-27

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 Hierarchical Status: Hierarchies applied and Condition Category is superseded (Risk Adjustment Hierarchical Status CodeSystem#applied-superseded)

> code: HCC 112: Fibrosis of lung and other chronic lung disorders (CMS Hierarchical Condition Categories[24]#112 "Fibrosis of lung and other chronic lung disorders")

> group

> > id

> > group-005

> 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)

> Risk Adjustment Evidence Status Date: 2021-09-27

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

> code: HCC 19: Diabetes without Complications (CMS Hierarchical Condition Categories[24]#19 "Diabetes without Complications")

> group

> > id

> > group-006

> 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)

> Risk Adjustment Evidence Status Date: 2020-12-15

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

> > Annotation

> > > url

> > > `annotator`

> > value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

> > > url

> > > `annotated`

> > value: 2021-11-01

> > > url

> > > `text`

> > value: Continue evaluation

> > > url

> > > code

> > value: Deferred (Coding Gap Annotation CodeSystem#deferred)

> code: HCC 84: Cardio-Respiratory Failure and Shock (CMS Hierarchical Condition Categories[24]#84 "Cardio-Respiratory Failure and Shock")

> 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)

> Risk Adjustment Evidence Status Date: 2021-03-15

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

> code: HCC 22: Morbid Obesity (CMS Hierarchical Condition Categories[24]#22 "Morbid Obesity")

> group

> > id

> > group-008

> 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)

> Risk Adjustment Evidence Status Date: 2021-09-27

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

> code: HCC 96: Specified Heart Arrhythmias (CMS Hierarchical Condition Categories[24]#96 "Specified Heart Arrhythmias")

> group

> > id

> > group-009

> 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)

> Risk Adjustment Evidence Status Date: 2020-07-15

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

> Confidence Scale: Medium (SNOMED CT#255508009)

> > Annotation

> > > url

> > > `annotator`

> > value: Practitioner/ra-prac01pat01 " HIPPOCRATES"

> > > url

> > > `annotated`

> > value: 2021-11-01

> > > url

> > > `text`

> > value: Not diagnosed

> > > url

> > > code

> > value: Assessed and not present (Coding Gap Annotation CodeSystem#assessed-not-present)

> > > url

> > > `relatedData`

> > value: id: 432203939

> code: HCC 110: Cystic Fibrosis (CMS Hierarchical Condition Categories[24]#110 "Cystic Fibrosis")

> group

> > id

> > group-010

> 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)

> Risk Adjustment Evidence Status Date: 2021-09-28

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

> code: HCC 83: Respiratory Arrest (CMS Hierarchical Condition Categories[24]#83 "Respiratory Arrest")

evaluatedResource:

- Condition/ra-condition02pat01
- Condition/ra-condition03pat01
- Condition/ra-condition08pat01
- Condition/ra-condition09pat01
- Condition/ra-condition10pat01
- Condition/ra-condition11pat01
- Condition/ra-condition17pat01
- Condition/ra-condition18pat01
- Condition/ra-condition33pat01
- Condition/ra-condition43pat01
- Condition/ra-condition44pat01
- Encounter/ra-encounter02pat01
- Encounter/ra-encounter03pat01
- Encounter/ra-encounter08pat01
- Encounter/ra-encounter09pat01
- Encounter/ra-encounter11pat01
- Encounter/ra-encounter43pat01
- Encounter/ra-encounter44pat01
- Observation/ra-obs21pat01