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FHIR IG Statistics: ValueSet/sample-cmshcc

Packagehl7.fhir.us.davinci-ra
TypeValueSet
Idsample-cmshcc
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/davinci-ra/https://build.fhir.org/ig/HL7/davinci-ra/ValueSet-sample-cmshcc.html
URLhttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc
Version2.1.0
Statusactive
Date2025-06-30T21:15:44+00:00
NameSampleCMSHCC
TitleSample CMS Hierarchical Condition Category
Realmus
Authorityhl7
DescriptionThis is a sample of the concepts that can be found in the CMS Hierarchical Condition Categories (CMS-HCC) code system version 24. The source of the codes included in this example was published at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories (CCs) that predict costs well. The condition categories (CCs) are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the Condition Categories (CCs) to capture the most costly diagnoses. Hierarchy logic is imposed on certain Condition Categories (CCs) to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.
CopyrightUsed by permission of HL7 International, all rights reserved Creative Commons License

Resources that use this resource

StructureDefinition
ra-datax-measurereportRisk Adjustment Data Exchange MeasureReport
ra-measurereportRisk Adjustment Coding Gap MeasureReport

Resources that this resource uses

CodeSystem
cmshccCMS Hierarchical Condition Categories
cmshccCMS Hierarchical Condition Categories

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ValueSet sample-cmshcc


Source

{
  "resourceType": "ValueSet",
  "id": "sample-cmshcc",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cqi"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 2,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/davinci-ra/ImplementationGuide/davinci-ra"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/davinci-ra/ImplementationGuide/davinci-ra"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.29.48.7"
    }
  ],
  "version": "2.1.0",
  "name": "SampleCMSHCC",
  "title": "Sample CMS Hierarchical Condition Category",
  "status": "active",
  "experimental": false,
  "date": "2025-06-30T21:15:44+00:00",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "This is a sample of the concepts that can be found in the CMS Hierarchical Condition Categories (CMS-HCC) code system version 24. The source of the codes included in this example was published at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories (CCs) that predict costs well. The condition categories (CCs) are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the Condition Categories (CCs) to capture the most costly diagnoses. Hierarchy logic is imposed on certain Condition Categories (CCs) to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US",
          "display": "United States of America"
        }
      ]
    }
  ],
  "copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
  "compose": {
    "include": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/cmshcc",
        "concept": [
          {
            "code": "22",
            "display": "Morbid Obesity"
          },
          {
            "code": "88",
            "display": "Angina Pectoris"
          },
          {
            "code": "112",
            "display": "Fibrosis of Lung and Other Chronic Lung Disorders"
          }
        ]
      }
    ]
  }
}