{
"description": "Diagnosis code(s) classified under a Condition Category, as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement.",
"_filename": "StructureDefinition-ra-qualifyingDxCode.json",
"package_name": "hl7.fhir.us.davinci-ra",
"date": "2026-04-07T00:27:39+10:00",
"derivation": "constraint",
"publisher": "HL7 International / Clinical Quality Information",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"name": "QualifyingDxCode",
"mapping": [ {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
} ],
"abstract": false,
"copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
"type": "Extension",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "QualifyingDxCode Extension",
"package_version": "3.0.0-ballot",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "cqi"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use"
} ],
"snapshot": {
"element": [ {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Extension",
"min": 0,
"definition": "Diagnosis codes classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement.",
"isModifier": false,
"short": "Qualifying diagnosis code(s)",
"max": "*",
"id": "Extension",
"condition": [ "ele-1" ],
"comment": "This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending.",
"base": {
"max": "*",
"min": 0,
"path": "Extension"
}
}, {
"path": "Extension.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Extension.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Extension.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "Extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"isModifier": false,
"short": "identifies the meaning of the extension",
"fixedUri": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Extension.url",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Extension.value[x]",
"min": 0,
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
"isModifier": false,
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "Extension.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Extension.value[x]",
"min": 0,
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
"isModifier": false,
"short": "Diagnosis codes classified under a Condition Category as defined by the risk adjustment model",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0"
},
"max": "1",
"id": "Extension.value[x]:valueCodeableConcept",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
},
"isSummary": false
}, {
"path": "Extension.value[x].id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Extension.value[x]:valueCodeableConcept.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Extension.value[x].extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Extension.value[x]:valueCodeableConcept.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Extension.value[x].extension",
"min": 0,
"definition": "A logical reference (i.e. a reference to ValueSet.url) to a value set (and optionally a version) that identifies a set of possible coded values for the element. This extension is used to convey a list of candidate codes when there is no formal code in the code system already defined that captures the intended set. For example, the concept of COVID preventative medications can be expressed as a value set because there is no specific code representing that concept.",
"isModifier": false,
"short": "Qualifying diagnosis codes provided as a value set",
"mapping": [ {
"map": "CWE.",
"identity": "v2"
}, {
"map": "CD.valueSet/CD.valueSetVersion",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/codeOptions" ]
} ],
"sliceName": "codeOptions",
"max": "1",
"id": "Extension.value[x]:valueCodeableConcept.extension:codeOptions",
"comment": "This extension SHALL NOT be used when an appropriate higher level concept code exists. This extension cannot be used on an element with a required binding. When this extension is used on an element with an extensible binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set unless none of the codes in the bound value set apply to the concept being communicated (based on human review). When this extension appears on a CodeableConcept, the CodeableConcept SHALL have no codings, and the text of the CodeableConcept SHOULD include the title of the referenced value set.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Extension.value[x].coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "Extension.value[x]:valueCodeableConcept.coding",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Extension.value[x].text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Extension.value[x]:valueCodeableConcept.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
} ]
},
"status": "active",
"id": "dec70080-1e52-40e7-9cc1-cb9f9b496612",
"kind": "complex-type",
"url": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.40.29.42.21",
"system": "urn:ietf:rfc:3986"
} ],
"context": [ {
"type": "element",
"expression": "MeasureReport.group"
} ],
"version": "3.0.0-ballot",
"differential": {
"element": [ {
"id": "Extension",
"max": "*",
"min": 0,
"path": "Extension",
"short": "Qualifying diagnosis code(s)",
"comment": "This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending.",
"definition": "Diagnosis codes classified under a Condition Category as defined by the risk adjustment model. This usually comes into play in the scenario where proprietary risk models are used and the mappings of ICD-10 codes to Condition Categories are not readily available. Note that whether qualifying codes may be included in a report depending may depend on individual Risk Adjustment model licensing agreement."
}, {
"id": "Extension.url",
"path": "Extension.url",
"type": [ {
"code": "uri"
} ],
"fixedUri": "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-qualifyingDxCode"
}, {
"id": "Extension.valueCodeableConcept",
"path": "Extension.valueCodeableConcept",
"type": [ {
"code": "CodeableConcept"
} ],
"short": "Diagnosis codes classified under a Condition Category as defined by the risk adjustment model",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0"
}
}, {
"id": "Extension.valueCodeableConcept.extension:codeOptions",
"max": "1",
"min": 0,
"path": "Extension.valueCodeableConcept.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/codeOptions" ]
} ],
"short": "Qualifying diagnosis codes provided as a value set",
"sliceName": "codeOptions"
} ]
},
"contact": [ {
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/cqi",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension"
}