HCC Suspecting
The HCC Suspecting mart contains concepts to identify suspecting conditions for risk adjustment.
The terminology set SNOMED-CT to ICD-10-CM Map is used to capture additional suspecting conditions coded in a system that is not part of the CMS HCC model. This use-case follows the default mapping guidance from NLM which specifies that the map priority rule of “TRUE” or “OTHERWISE TRUE” should be applied if nothing further is known about the patient’s condition.
list
This final model displays the list of suspecting conditions per patient with the reason and contributing factors.
| Column | Data Type | Description | Terminology |
|---|
summary
This final model displays a rollup of suspecting conditions per patient.
| Column | Data Type | Description | Terminology |
|---|
value sets
See the value set data dictionaries here.