Qualifying Diagnoses for CMS-HCC Calculations
- 19 Apr 2024
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Qualifying Diagnoses for CMS-HCC Calculations
- Updated on 19 Apr 2024
- 1 Minute to read
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Article Summary
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Object Description
One record per distinct patient-diagnosis code-calendar date triple for records that are qualifying for use in calculating HCC/RAF score, either because they meet the claims or billing data standard or because they are associated with an allowed MAO-004 record. Includes patient-code-date triples with disallowed MAO-004 records if there is a diagnosis from a qualifying claim or bill present on that same date; this provides flexibility to downstream logic as to whether to use only allowed MAO-004 records or to cast a wider net.
Metadata
- Table Name: ursa.so_ursa_hcc_cond_001
- Layer: SYNTHETIC_OBJECT
- Object Type: Single Stack
- Temporal Class: Event
- Case ID: Patient ID, Diagnosis Effective Date, Diagnosis ICD-10-CM Code
- Event Date:
- Primary Key: Patient ID, Diagnosis Effective Date, Diagnosis ICD-10-CM Code
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