RiskAdjustmentConditionCategoryType

Risk Adjustment Condition Category Type Codes

activeDa Vinci Risk Adjustment2.1.0complete3 concepts

Code sytstem that indicates whether it is a suspected Condition Category (CC) gap, a historic Condition Category (CC) gap, or a net-new Condition Category (CC). Historic, suspected, and net-new are mutually exclusive.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type
ID
cc-type
Version
2.1.0
Publisher
HL7 International / Clinical Quality Information
Case Sensitive
Yes

Concepts (3)

CodeDisplayDefinition
historicHistoric Condition Category GapHistoric Condition Category (CC) Gap. Historic Condition Category (CC) is based on verified data from any clinical evaluation period.
suspectedSuspected Condition Category GapSuspected Condition Category (CC) Gap. A member has never had this as a verified Condition Category (CC), but when a Server runs a suspecting algorithm, suspected Condition Categories (CCs) are identified.
net-newNet-New Condition CategoryNet-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 cannot be open-gap.