URSA-HCC-R02: Qualifying CMS-HCC Diagnoses

Measure Description

Registry of distinct qualifying CMS-HCC ICD-10-CM diagnosis codes. Each record is a distinct patient-code-date triple; that is, multiple instances of the same diagnosis code documented on the same day for the same patient are captured as a single record in the registry.

Metadata

• Measure Type: Registry
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Patient ID, Diagnosis Effective Date, Diagnosis ICD-10-CM Code
• Target Direction: None

Published Fields

• Data Model Keys

  • Patient ID
  • Primary Diagnosis Document ID
  • Primary Encounter ID
  • Primary Encounter Facility Provider ID
  • Primary Encounter Attending Provider ID
  • Primary Encounter Service Provider ID
  • Primary Encounter Provider Group ID

• Date Fields

  • Diagnosis Effective Date
  • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)

• Diagnosis Fields

  • Diagnosis ICD-10-CM Code
  • Diagnosis ICD-10-CM Description

• Module Fields

  • Is CMS MAO-004 Diagnosis

• Encounter Fields

  • Is Diagnoses within URSA-CORE Encounter
  • Ursa Encounter Type Tier 1 Category
  • Ursa Encounter Type Tier 2 Category
  • Is Clinician Office Visit Encounter
  • Is Primary Care Clinician Office Visit

• Provider Fields

  • Primary Encounter Facility Provider Description
  • Primary Encounter Facility Provider Taxonomy Description
  • Primary Encounter Attending Provider Description
  • Primary Encounter Service Provider Description
  • Primary Encounter Service Provider Taxonomy Description
  • Primary Encounter Provider Group Description

• Metadata Fields

  • Is Claim Diagnosis
  • Is Bill Diagnosis
  • Is Acceptable Diagnosis Document Type

• Measure Fields

  • Denominator