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  1. FHIR Specification Feedback
  2. FHIR-37350

Example MeasureReport02 Group vs Condition Data Conflict

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci Risk Adjustment (FHIR)
    • 0.1.0 [deprecated]
    • Clinical Quality Information
    • Condition10pat01: Long term (current) use of insulin
      ra-measurereport02: Risk Adjustment Measure Report
    • Examples
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      Correct Condition10pat01 from "J45.31: Mild persistent asthma with (acute) exacerbation" to "Z79.4 Long term (current) use of insulin" (which rolls up to HCC 19)

      (Note: keep group-005 linking to Condition10pat01, after correcting Condition10pat01, group-005 would be linking to the right diagnosis)

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      Correct Condition10pat01 from "J45.31: Mild persistent asthma with (acute) exacerbation" to "Z79.4 Long term (current) use of insulin" (which rolls up to HCC 19) (Note: keep group-005 linking to Condition10pat01, after correcting Condition10pat01, group-005 would be linking to the right diagnosis)
    • Floyd Eisenberg / Juliet Rubini : 9-0-0
    • Correction
    • Non-substantive
    • Yes

    Description

      The linked relevant evaluatedResources conflict with the example of an CMS-RxHCC 31 suspected Risk Adjustment Gap

      Suggested update is to replace the Group-005 evaluatedResource from Condition10pat01 to Condition02pat01 and update appropriate encounter data linked to Group-005

       

      However, Condition02pat01 is with complication so maybe we should update the HCC code as well. CMS-RxHCC 30 seems like the correct category for this.

       

      Heavily Realated to issue FHIR-37347

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            Unassigned Unassigned
            cody_danielshak Cody Danielshak
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              Updated:
              Resolved: