description: This profile is based on the [MeasureReport](http://hl7.org/fhir/R4/measurereport.html) to represent a risk adjustment coding gap report.
package_name: hl7.fhir.us.davinci-ra
derivation: constraint
name: RiskAdjustmentCodingGapMeasureReport
type: MeasureReport
elements:
  evaluatedResource:
    short: An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
    mustSupport: true
    index: 20
    extensions:
      groupReference: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference', min: 0, type: Extension, mustSupport: true, index: 21}
    elements:
      extension:
        type: Extension
        mustSupport: true
        url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
        index: 21
        slicing:
          slices:
            groupReference:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference', index: 21}
              min: 0
  date: {short: When the report was generated, mustSupport: true, index: 5}
  group:
    short: A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
    mustSupport: true
    array: true
    index: 10
    elements:
      id: {mustSupport: true, index: 11}
      extension:
        type: Extension
        mustSupport: true
        url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType
        index: 12
        slicing:
          slices:
            suspectType:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType', index: 12}
              min: 0
              max: 1
            evidenceStatus:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus', index: 13}
              min: 0
              max: 1
            evidenceStatusDate:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate', index: 14}
              min: 0
              max: 1
            hierarchicalStatus:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus', index: 15}
              min: 0
              max: 1
            confidenceScale:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale', index: 16}
              min: 0
              max: 1
            annotation:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation', index: 17}
              min: 0
      code:
        short: Condition Category (CC) code for a Risk Adjustment Model
        type: CodeableConcept
        mustSupport: true
        binding: {strength: example, valueSet: 'http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc'}
        index: 18
      stratifier:
        elements:
          code: {index: 19}
    required: [id]
    extensions:
      suspectType: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType', min: 0, max: 1, type: Extension, mustSupport: true, index: 12}
      evidenceStatus: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus', min: 0, max: 1, type: Extension, mustSupport: true, index: 13}
      evidenceStatusDate: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 14}
      hierarchicalStatus: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus', min: 0, max: 1, type: Extension, mustSupport: true, index: 15}
      confidenceScale: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale', min: 0, max: 1, type: Extension, mustSupport: true, index: 16}
      annotation: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation', min: 0, type: Extension, mustSupport: true, index: 17}
  type:
    type: code
    short: The type code is fixed to 'individual' for a risk adjustment coding gap report
    pattern: {type: Code, value: individual}
    mustSupport: true
    index: 2
  measure: {type: canonical, short: 'This references a measure that represents a risk adjustment model, such as CMS-HCC V24.', mustSupport: true, index: 3}
  extension:
    type: Extension
    mustSupport: true
    url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
    index: 0
    slicing:
      slices:
        clinicalDataCollectionDeadline:
          match: {}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline', index: 0}
          min: 0
          max: 1
  reporter:
    short: Organization that generated the MeasureReport
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization']
    type: Reference
    mustSupport: true
    index: 6
  status: {mustSupport: true, index: 1}
  period:
    constraint:
      ra-1: {human: Date precision SHALL be at least to day ( YYYY-MM-DD ), severity: error, expression: 'start.value.matches(''^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*'') and end.value.matches(''^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*'')'}
    short: Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes.
    type: Period
    mustSupport: true
    index: 7
    elements:
      start: {mustSupport: true, index: 8}
      end: {mustSupport: true, index: 9}
    required: [start, end]
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient']
    index: 4
package_version: 2.0.0-ballot
extensions:
  clinicalDataCollectionDeadline: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline', min: 0, max: 1, type: Extension, mustSupport: true, index: 0}
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport
base: http://hl7.org/fhir/StructureDefinition/MeasureReport
version: 2.0.0-ballot
required: [reporter, subject, date, period]