description: This profile is based on the [MeasureReport](http://hl7.org/fhir/R4/measurereport.html) to represent a risk adjustment coding gap report. Payer runs risk adjustment engine and uses this profile to represent the risk adjustment Condition Category (CC) coding gaps and their detailed information for a patient. package_name: hl7.fhir.us.davinci 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: 24 extensions: groupReference: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference', min: 0, type: Extension, mustSupport: true, index: 25} elements: extension: type: Extension mustSupport: true url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference index: 25 slicing: slices: groupReference: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference', index: 25} min: 0 date: {short: When the report was generated, mustSupport: true, index: 8} 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: 13 elements: id: {mustSupport: true, index: 14} extension: type: Extension mustSupport: true url: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType index: 15 slicing: slices: ccType: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType', index: 15} min: 1 max: 1 dxCode: match: {} schema: {type: Extension, short: 'diagnosis code: if ccType historic or net-new, this is documented condition; if ccType is suspected, this is inferred/suspected condition.', mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-dxCode', index: 16} min: 0 evidenceStatus: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus', index: 17} min: 0 max: 1 evidenceStatusDate: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate', index: 18} min: 0 max: 1 hierarchicalStatus: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus', index: 19} min: 0 max: 1 confidenceScale: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale', index: 20} min: 0 max: 1 ccRemark: match: {} schema: {type: Extension, short: Remark added to a Condition Category, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark', index: 21} 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: 22 stratifier: elements: code: {index: 23} required: [id] extensions: ccType: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType', min: 1, max: 1, type: Extension, mustSupport: true, index: 15} dxCode: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-dxCode', min: 0, type: Extension, short: 'diagnosis code: if ccType historic or net-new, this is documented condition; if ccType is suspected, this is inferred/suspected condition.', mustSupport: true, index: 16} evidenceStatus: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus', min: 0, max: 1, type: Extension, mustSupport: true, index: 17} evidenceStatusDate: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 18} hierarchicalStatus: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus', min: 0, max: 1, type: Extension, mustSupport: true, index: 19} confidenceScale: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale', min: 0, max: 1, type: Extension, mustSupport: true, index: 20} ccRemark: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark', min: 0, type: Extension, short: Remark added to a Condition Category, mustSupport: true, index: 21} 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: 5 measure: {type: canonical, short: 'This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28.', mustSupport: true, index: 6} extension: type: Extension mustSupport: true url: http://hl7.org/fhir/StructureDefinition/measurereport-category index: 0 slicing: slices: measurereport-category: match: {} schema: type: Extension mustSupport: true url: http://hl7.org/fhir/StructureDefinition/measurereport-category index: 0 elements: value[x]: elements: coding: index: 1 elements: code: pattern: {type: Code, value: ra} index: 2 required: [code] required: [coding] clinicalDataCollectionDeadline: match: {} schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline', index: 3} 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: 9 status: {mustSupport: true, index: 4} period: constraint: ra-1: {human: Date precision SHALL be at least to day ( YYYY-MM-DD ), severity: error, expression: start.toString().length()>9 and end.toString().length()>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: 10 elements: start: {mustSupport: true, index: 11} end: {mustSupport: true, index: 12} required: [start, end] subject: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'] index: 7 package_version: ra-2.0.0 extensions: measurereport-category: url: http://hl7.org/fhir/StructureDefinition/measurereport-category type: Extension mustSupport: true index: 0 elements: value[x]: elements: coding: index: 1 elements: code: pattern: {type: Code, value: ra} index: 2 required: [code] required: [coding] clinicalDataCollectionDeadline: {url: 'http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline', min: 0, max: 1, type: Extension, mustSupport: true, index: 3} 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 required: [reporter, subject, date, period]