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Hierarchical Condition Category (HCC) API v1

The Hierarchical Condition Category (HCC) API provides information about the quality of the clinical documentation in a patient’s record that is used for risk adjustment. This information can be used to fill gaps in documentation, which may make patients’ risk scores more accurate.

The purpose of risk adjustment is to reduce the influence of risk selection on the premiums that insurance plans charge. The risk score values in risk adjustment are used as inputs to adjust capitated payments made to insurance plans. There are a number of different risk adjustment models defined in the health care industry, several of which use the HCC method. The risk score values associated with risk adjustment models using the HCC method are referred to as Risk Adjustment Factor (RAF) scores.

HCCs are derived from ICD codes through retrospective review of claims data. An ICD code maps to exactly one HCC, but not all ICD codes map to an HCC. HCCs are termed hierarchical because, for some disease states such as diabetes, multiple HCCs capture differing severity of illness. Within an HCC grouping, a patient is assigned only the HCC that corresponds to the most severe manifestation documented. For example, if review of a beneficiary’s claims data finds ICD codes mapping to both HCC 17 Diabetes With Acute Complications (such as ICD-10 code E0811) and HCC 19 Diabetes Without Complication (such as ICD-10 code E089), the model assigns only HCC 17, because it is the more severe manifestation of diabetes.

URL: https://cernerdemo.api.us.healtheintent.com/hcc/v1

Persistent HCCs

Operations about Persistent HCCs

Retrieve a List of Persistent HCCs

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/persistent-hccs',
  query: {
  'patientId' => 'string'
}, headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/persistent-hccs?patientId=type,string \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "patient": {
        "id": "17d0677b-28e6-4648-9159-1e114eb7b829",
        "population": {
          "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"
        }
      },
      "hierarchicalConditionCategory": {
        "id": "0b424e9d-b74a-4b78-9dde-22685ae9cdec"
      },
      "status": "SATISFIED",
      "pastPeriodSupportingData": [
        {
          "condition": {
            "id": "0001f5f1328aab3bdb67a6ca32d025bdfaceda230268357dff364d93366b6412"
          },
          "effectiveDate": "2017-04-24"
        }
      ],
      "currentPeriodSupportingData": [
        {
          "condition": {
            "id": "0001f5f1328aab3bdb67a6ca32d025bdfaceda230268357dff364d93366b64c2"
          },
          "effectiveDate": "2018-04-24"
        }
      ],
      "pipeline": {
        "id": "a426149a-c19c-413a-8d9f-d7988aec4a91"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/persistent-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/persistent-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/persistent-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/persistent-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=20&limit=20"
}

GET /pipelines/{pipelineId}/persistent-hccs

Retrieves a list of persistent HCCs.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline -
patientId query string true N/A The identifier of the patient within the population -
status query string false N/A The status of the persistent HCC. If the parameter is not provided, then persistent HCCs from all statuses will be returned. PENDING, SATISFIED
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false status A comma-separated list of fields by which to sort. status, -status

Response Statuses

Status Meaning Description Schema
200 OK A collection of persistent HCC objects. PersistentHccs
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Reference

The HCC reference content defines the specifications for the risk adjustment models that use the HCC methodology.

Retrieve a List of Condition Category Codes

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "hierarchicalConditionCategory": {
        "id": "b5965131-3b98-4f35-bd27-54c771c8a03e"
      },
      "code": {
        "code": "E11.649",
        "display": "Type 2 diabetes mellitus with hypoglycemia without coma",
        "system": "2.16.840.1.113883.6.90"
      }
    },
    {
      "hierarchicalConditionCategory": {
        "id": "b5965131-3b98-4f35-bd27-54c771c8a03e"
      },
      "code": {
        "code": "E09.638",
        "display": "Drug or chemical induced diabetes mellitus with other oral complications",
        "system": "2.16.840.1.113883.6.90"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/condition-category-codes?offset=20&limit=20"
}

GET /condition-category-codes

Retrieves a list of condition category codes.

Parameters

Parameter In Type Required Default Description Accepted Values
hierarchicalConditionCategoryId query string false N/A The ID of the HCC that all returned codes should be related to. -
codeSystem query string false N/A The code system. Requires code. -
code query string false N/A The code. Requires codeSystem. -
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false codeDisplay A comma-separated list of fields by which to sort. codeDisplay, -codeDisplay

Response Statuses

Status Meaning Description Schema
200 OK Collection of condition category code objects. ConditionCategoryCodes
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Retrieve a List of Hierarchical Condition Categories

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/hierarchical-condition-categories', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/hierarchical-condition-categories \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "id": "0b424e9d-b74a-4b78-9dde-22685ae9cdec",
      "riskAdjustmentModel": {
        "id": "b923179c-9617-4ac5-8601-8054755a2a5c"
      },
      "categoryNumber": 17,
      "name": "Diabetes with Acute Complications",
      "concept": {
        "contextId": "4FAFA7EED0F148519CAA4107304765CF",
        "name": "HCC17 Diabetes with Acute Complication",
        "alias": "HCC_17_DIABETES_WITH_ACUTE_COMPLICATIONS_CLIN"
      },
      "hierarchy": [
        "b5965131-3b98-4f35-bd27-54c771c8a03e",
        "c2ca59de-1978-4561-8c40-b4769b9939db"
      ],
      "createdAt": "2018-06-30T06:25:13Z",
      "updatedAt": "2018-07-30T06:25:13Z"
    },
    {
      "id": "b5965131-3b98-4f35-bd27-54c771c8a03e",
      "riskAdjustmentModel": {
        "id": "b923179c-9617-4ac5-8601-8054755a2a5c"
      },
      "categoryNumber": 18,
      "name": "Diabetes with Chronic Complications",
      "concept": {
        "contextId": "4FAFA7EED0F148519CAA4107304765CF",
        "name": "HCC18 Diabetes with Chronic Complication",
        "alias": "HCC_18_DIABETES_WITH_CHRONIC_COMPLICATIONS_CLIN"
      },
      "hierarchy": [
        "c2ca59de-1978-4561-8c40-b4769b9939db"
      ],
      "createdAt": "2018-06-30T06:25:13Z",
      "updatedAt": "2018-07-30T06:25:13Z"
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suspected-hcc-definitions?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suspected-hcc-definitions?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suspected-hcc-definitions?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suspected-hcc-definitions?offset=20&limit=20"
}

GET /hierarchical-condition-categories

Retrieves a list of HCCs.

Parameters

Parameter In Type Required Default Description Accepted Values
riskAdjustmentModelId query string false N/A The ID of the HCC risk adjustment model that all returned HCCs should be related to. This parameter will be ignored if one or more ID parameter values are also specified. -
id query array[string] false N/A The IDs of the HCCs. This query parameter can be repeated multiple times to query for multiple IDs at a time. -
conceptAlias query array[string] false N/A The concept aliases used by the HCCs. This query parameter can be repeated multiple times to query for multiple concept aliases at a time. This parameter will be ignored if one or more ID parameter values are also specified. -
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false name A comma-separated list of fields by which to sort. name, -name, categoryNumber, -categoryNumber, createdAt, -createdAt, updatedAt, -updatedAt

Response Statuses

Status Meaning Description Schema
200 OK A collection of HCC objects. HierarchicalConditionCategories
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Retrieve a Single Hierarchical Condition Category

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/hierarchical-condition-categories/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/hierarchical-condition-categories/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "id": "0b424e9d-b74a-4b78-9dde-22685ae9cdec",
  "riskAdjustmentModel": {
    "id": "b923179c-9617-4ac5-8601-8054755a2a5c"
  },
  "categoryNumber": 17,
  "name": "Diabetes with Acute Complications",
  "concept": {
    "contextId": "4FAFA7EED0F148519CAA4107304765CF",
    "name": "HCC17 Diabetes with Acute Complication",
    "alias": "HCC_17_DIABETES_WITH_ACUTE_COMPLICATIONS_CLIN"
  },
  "hierarchy": [
    "b5965131-3b98-4f35-bd27-54c771c8a03e",
    "c2ca59de-1978-4561-8c40-b4769b9939db"
  ],
  "createdAt": "2018-06-30T06:25:13Z",
  "updatedAt": "2018-07-30T06:25:13Z"
}

GET /hierarchical-condition-categories/{hierarchicalConditionCategoryId}

Retrieves a single HCC.

Parameters

Parameter In Type Required Default Description Accepted Values
hierarchicalConditionCategoryId path string true N/A The ID of the HCC. -

Response Statuses

Status Meaning Description Schema
200 OK A single HCC object. HierarchicalConditionCategory
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Retrieve a List of Risk Adjustment Models

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "id": "b923179c-9617-4ac5-8601-8054755a2a5c",
      "type": "CMS-HCC",
      "name": "CMS HCC version 22, Payment Year 2018",
      "version": "22",
      "year": 2018,
      "createdAt": "2018-06-29T06:25:13Z",
      "updatedAt": "2018-06-30T06:25:13Z"
    },
    {
      "id": "08d00984-c012-4578-b526-5959fdc17dcd",
      "type": "CMS-HCC",
      "name": "CMS HCC version 23, Payment Year 2019",
      "version": "23",
      "year": 2019,
      "createdAt": "2018-06-30T06:25:13Z",
      "updatedAt": "2018-07-30T06:25:13Z"
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models?offset=20&limit=20"
}

GET /risk-adjustment-models

Retrieves a list of risk adjustment models.

Parameters

Parameter In Type Required Default Description Accepted Values
type query string false N/A The type of HCC risk adjustment model being used. If the parameter is not provided, then risk models from all supported model types will be returned. CMS-HCC, HHS-HCC
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false name A comma-separated list of fields by which to sort. name, -name, createdAt, -createdAt, updatedAt, -updatedAt

Response Statuses

Status Meaning Description Schema
200 OK A collection of risk adjustment model objects. RiskAdjustmentModels
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Retrieve a Single Risk Adjustment Model

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/risk-adjustment-models/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "id": "b923179c-9617-4ac5-8601-8054755a2a5c",
  "type": "CMS-HCC",
  "name": "CMS HCC version 22, Payment Year 2018",
  "version": "22",
  "year": 2018,
  "createdAt": "2018-06-29T06:25:13Z",
  "updatedAt": "2018-06-30T06:25:13Z"
}

GET /risk-adjustment-models/{riskAdjustmentModelId}

Retrieves a single risk adjustment model.

Parameters

Parameter In Type Required Default Description Accepted Values
riskAdjustmentModelId path string true N/A The ID of the risk adjustment model. -

Response Statuses

Status Meaning Description Schema
200 OK A single risk adjustment model object. RiskAdjustmentModel
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Pipeline

The resources for managing the HCC pipelines.

An HCC pipeline represents the concept of an isolated execution environment for processing HCC-related outcomes. The pipeline is required prior to being able to generate and access patient-level HCC data.

Note: A limit of only one pipeline per tenant is currently available. Future development will allow for additional pipelines per tenant to facilitate validation efforts or running multiple HCC risk adjustment models simultaneously.

Create a Pipeline

Example Request:




require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Content-Type' => 'application/json',
  'Accept' => 'application/json'
}

result = HTTParty.post('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines', headers: headers, body: {"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"name":"HCC production pipeline"}.to_json )

print JSON.pretty_generate(result)




# You can also use wget
curl -X POST https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines \
-H 'Authorization: {auth_header}' \
-H 'Content-Type: application/json' \ \
-H 'Accept: application/json' \
-d {"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"name":"HCC production pipeline"}

Example response

{
  "id": "09caa9f6-c384-4ad4-a4e2-203e1acee6db",
  "name": "HCC production pipeline",
  "createdAt": "2018-05-14T12:23:12Z",
  "createdBy": {
    "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
  }
}

POST /pipelines

Creates a pipeline.

Parameters

Parameter In Type Required Default Description Accepted Values
body body postPipelines true N/A No description -

Response Statuses

Status Meaning Description Schema
201 Created A pipeline object. HccPipeline
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Response Headers

Status Header Type Format Description
201 Location string The URL location of the created pipeline.

Retrieve a List of Pipelines

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "id": "a426149a-c19c-413a-8d9f-d7988aec4a91",
      "name": "HCC production pipeline",
      "createdAt": "2018-05-14T12:23:12Z",
      "createdBy": {
        "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines?offset=20&limit=20"
}

GET /pipelines

Retrieves a list of pipelines.

Parameters

Parameter In Type Required Default Description Accepted Values
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false name A comma-separated list of fields by which to sort. name, -name, createdAt, -createdAt

Response Statuses

Status Meaning Description Schema
200 OK A collection of pipeline objects. HccPipelines
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Retrieve a Single Pipeline

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

GET /pipelines/{pipelineId}

Retrieves a single pipeline.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The unique identifier for the pipeline -

Response Statuses

Status Meaning Description Schema
200 OK Retrieves a single pipeline. HccPipeline
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Suppression

The resources for managing the suppression of HCC outcomes.

A personnel- or system-initiated suspected HCC suppression is created anytime a dispute occurs with the recommendation of an HCC for documentation in your electronic health record (EHR). Each suppression requires a suppression-reason value to explain why the outcome is disputed, and a free-text comment can also be provided to give additional clarification for why the suppression is needed.

Create a Suspected HCC Suppression

Example Request:




require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Content-Type' => 'application/json',
  'Accept' => 'application/json'
}

result = HTTParty.post('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions', headers: headers, body: {"comment":"This patient does not appear to have the suspected condition.","endEffective":"2019-05-14T12:23:12Z","hierarchicalConditionCategory":{"id":"b5965131-3b98-4f35-bd27-54c771c8a03e"},"suppressionReason":{"id":"5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"},"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"}}.to_json )

print JSON.pretty_generate(result)




# You can also use wget
curl -X POST https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions \
-H 'Authorization: {auth_header}' \
-H 'Content-Type: application/json' \ \
-H 'Accept: application/json' \
-d {"comment":"This patient does not appear to have the suspected condition.","endEffective":"2019-05-14T12:23:12Z","hierarchicalConditionCategory":{"id":"b5965131-3b98-4f35-bd27-54c771c8a03e"},"suppressionReason":{"id":"5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"},"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"}}

POST /pipelines/{pipelineId}/patients/{patientId}/suspected-hcc-suppressions

Creates a suspected HCC suppression.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId path string true N/A The identifier of the patient within the population. -
body body postPipelinesPipelineidPatientsPatientidSuspectedHccSuppressions true N/A No description -

Response Statuses

Status Meaning Description Schema
201 Created A suspected HCC suppression object. SuspectedHccSuppression
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Response Headers

Status Header Type Format Description
201 Location string The URL of the created suspected HCC suppression.

Retrieve a List of Suspected HCC Suppressions

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "id": "65752b39-78ed-496d-983e-64b361ad7890",
      "patient": {
        "id": "17d0677b-28e6-4648-9159-1e114eb7b829",
        "population": {
          "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"
        }
      },
      "hierarchicalConditionCategory": {
        "id": "0b424e9d-b74a-4b78-9dde-22685ae9cdec"
      },
      "suppressionReason": {
        "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"
      },
      "comment": "This patient does not appear to have the suspected condition.",
      "endEffective": "2019-05-14T12:23:12Z",
      "pipeline": {
        "id": "a426149a-c19c-413a-8d9f-d7988aec4a91"
      },
      "createdAt": "2018-05-14T12:23:12Z",
      "createdBy": {
        "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
      },
      "updatedAt": "2018-05-15T12:23:12Z",
      "updatedBy": {
        "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hcc-suppressions?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hcc-suppressions?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hcc-suppressions?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hcc-suppressions?offset=20&limit=20"
}

GET /pipelines/{pipelineId}/patients/{patientId}/suspected-hcc-suppressions

Retrieves a list of suspected HCC suppressions.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId path string true N/A The identifier of the patient within the population. -
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false createdAt A comma-separated list of fields by which to sort. createdAt, -createdAt, updatedAt, -updatedAt

Response Statuses

Status Meaning Description Schema
200 OK A collection of suspected HCC suppression objects. SuspectedHccSuppressions
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Remove a Suspected HCC Suppression

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.delete('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X DELETE https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

DELETE /pipelines/{pipelineId}/patients/{patientId}/suspected-hcc-suppressions/{suspectedHccSuppressionId}

Removes a suspected HCC suppression.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId path string true N/A The identifier of the patient within the population. -
suspectedHccSuppressionId path string true N/A The unique identifier for the suspected HCC suppression. -

Response Statuses

Status Meaning Description Schema
204 No Content No content. None
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Not Found Error

Update a Suspected HCC Suppression

Example Request:




require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Content-Type' => 'application/json',
  'Accept' => 'application/json'
}

result = HTTParty.put('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc', headers: headers, body: {"comment":"This patient does not appear to have the suspected condition.","endEffective":"2019-05-14T12:23:12Z","hierarchicalConditionCategory":{"id":"b5965131-3b98-4f35-bd27-54c771c8a03e"},"suppressionReason":{"id":"5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"},"updatedBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"}}.to_json )

print JSON.pretty_generate(result)




# You can also use wget
curl -X PUT https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Content-Type: application/json' \ \
-H 'Accept: application/json' \
-d {"comment":"This patient does not appear to have the suspected condition.","endEffective":"2019-05-14T12:23:12Z","hierarchicalConditionCategory":{"id":"b5965131-3b98-4f35-bd27-54c771c8a03e"},"suppressionReason":{"id":"5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"},"updatedBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"}}

PUT /pipelines/{pipelineId}/patients/{patientId}/suspected-hcc-suppressions/{suspectedHccSuppressionId}

Updates a suspected HCC suppression.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId path string true N/A The identifier of the patient within the population. -
suspectedHccSuppressionId path string true N/A The unique identifier for the suspected HCC suppression. -
body body putPipelinesPipelineidPatientsPatientidSuspectedHccSuppressions true N/A No description -

Response Statuses

Status Meaning Description Schema
204 No Content No content. None
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Not Found Error

Retrieve a Single Suspected HCC Suppression

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/patients/65752b39-78ed-496d-983e-64b361ad7891/suspected-hcc-suppressions/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

GET /pipelines/{pipelineId}/patients/{patientId}/suspected-hcc-suppressions/{suspectedHccSuppressionId}

Retrieves a single suspected HCC suppression.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId path string true N/A The identifier of the patient within the population. -
suspectedHccSuppressionId path string true N/A The unique identifier for the suspected HCC suppression. -

Response Statuses

Status Meaning Description Schema
200 OK Retrieves a single suspected HCC suppression. SuspectedHccSuppression
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Create a Suppression Reason

Example Request:




require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Content-Type' => 'application/json',
  'Accept' => 'application/json'
}

result = HTTParty.post('https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons', headers: headers, body: {"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"display":"No longer applicable"}.to_json )

print JSON.pretty_generate(result)




# You can also use wget
curl -X POST https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons \
-H 'Authorization: {auth_header}' \
-H 'Content-Type: application/json' \ \
-H 'Accept: application/json' \
-d {"createdBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"display":"No longer applicable"}

Example response

{
  "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce",
  "display": "No longer applicable",
  "status": "ACTIVE",
  "createdAt": "2018-05-14T12:23:12Z",
  "createdBy": {
    "id": "f89fa3dd-57a8-494b-b157-4640ccc081e3"
  },
  "updatedAt": "2018-05-14T12:23:12Z",
  "updatedBy": {
    "id": "f89fa3dd-57a8-494b-b157-4640ccc081e3"
  }
}

POST /suppression-reasons

Creates a suppression reason.

Parameters

Parameter In Type Required Default Description Accepted Values
body body postSuppressionReasons true N/A No description -

Response Statuses

Status Meaning Description Schema
201 Created A suppression reason object. SuppressionReason
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Response Headers

Status Header Type Format Description
201 Location string The URL of the created suppression reason.

Retrieve a List of Suppression Reasons

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce",
      "display": "No longer applicable",
      "status": "ACTIVE",
      "createdAt": "2018-05-14T12:23:12Z",
      "createdBy": {
        "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
      },
      "updatedAt": "2018-05-15T12:23:12Z",
      "updatedBy": {
        "id": "d7edf791-7ef6-433c-a6f9-49dbc09f24a3"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons?offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons?offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons?offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons?offset=20&limit=20"
}

GET /suppression-reasons

Retrieves a list of suppression reasons.

Parameters

Parameter In Type Required Default Description Accepted Values
status query array[string] false N/A The status of the suppression reason. This query parameter can be repeated multiple times to query for multiple statuses at a time. The default behavior is to return reasons from all statuses. -
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false display A comma-separated list of fields by which to sort. display, -display, createdAt, -createdAt, updatedAt, -updatedAt

Response Statuses

Status Meaning Description Schema
200 OK A collection of suppression reason objects. SuppressionReasons
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error

Update a Suppression Reason

Example Request:




require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Content-Type' => 'application/json',
  'Accept' => 'application/json'
}

result = HTTParty.put('https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons/206d2277-827b-478e-b543-308e28d74fdc', headers: headers, body: {"updatedBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"display":"No longer applicable still","active":"ACTIVE"}.to_json )

print JSON.pretty_generate(result)




# You can also use wget
curl -X PUT https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Content-Type: application/json' \ \
-H 'Accept: application/json' \
-d {"updatedBy":{"id":"f89fa3dd-57a8-494b-b157-4640ccc081e3"},"display":"No longer applicable still","active":"ACTIVE"}

PUT /suppression-reasons/{reasonId}

Updates a suppression reason.

Parameters

Parameter In Type Required Default Description Accepted Values
reasonId path string true N/A The unique identifier for the suppression reason -
body body putSuppressionReasons true N/A No description -

Response Statuses

Status Meaning Description Schema
204 No Content No content. None
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Not Found Error

Retrieve a Single Suppression Reason

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons/206d2277-827b-478e-b543-308e28d74fdc', headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/suppression-reasons/206d2277-827b-478e-b543-308e28d74fdc \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

GET /suppression-reasons/{reasonId}

Retrieves a single suppression reason.

Parameters

Parameter In Type Required Default Description Accepted Values
reasonId path string true N/A The unique identifier for the suppression reason -

Response Statuses

Status Meaning Description Schema
200 OK Retrieves a single suppression reason. SuppressionReason
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Suspected HCC

A suspected HCC is an HCC that is likely to be present for a patient but is not supported by a documented condition in the patient’s longitudinal record. Suspected HCCs are based on laboratory results, medications, and procedures. Both supporting and possible competing clinical facts are provided to help a user decide whether to document an HCC-related problem or diagnosis for the patient.

Retrieve a List of Suspected HCCs

Example Request:


require 'httparty' # Using HTTParty 0.16.2
require 'json'

headers = {
  'Authorization' => '<auth_header>',
  'Accept' => 'application/json'
}

result = HTTParty.get('https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/suspected-hccs',
  query: {
  'patientId' => 'string'
}, headers: headers)

print JSON.pretty_generate(result)


# You can also use wget
curl -X GET https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/65752b39-78ed-496d-983e-64b361ad7890/suspected-hccs?patientId=type,string \
-H 'Authorization: {auth_header}' \
-H 'Accept: application/json'

Example response

{
  "items": [
    {
      "patient": {
        "id": "17d0677b-28e6-4648-9159-1e114eb7b829",
        "population": {
          "id": "5d0f9ff9-d3b8-47e0-86a1-13d500d833ce"
        }
      },
      "hierarchicalConditionCategory": {
        "id": "0b424e9d-b74a-4b78-9dde-22685ae9cdec"
      },
      "stratification": "HIGH",
      "supportingData": [
        {
          "name": "hba1c",
          "textValue": "6.8",
          "serviceDate": "2017-08-15T19:20:00.000Z"
        }
      ],
      "competingData": [
        {
          "name": "gestational_diabetes_present",
          "textValue": "false"
        }
      ],
      "suppressed": true,
      "suppression": {
        "id": "65752b39-78ed-496d-983e-64b361ad7890"
      },
      "pipeline": {
        "id": "a426149a-c19c-413a-8d9f-d7988aec4a91"
      }
    }
  ],
  "totalResults": 21,
  "firstLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=0&limit=20",
  "lastLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=20&limit=20",
  "prevLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=0&limit=20",
  "nextLink": "https://cernerdemo.api.us.healtheintent.com/hcc/v1/pipelines/a426149a-c19c-413a-8d9f-d7988aec4a91/suspected-hccs?patientId=17d0677b-28e6-4648-9159-1e114eb7b829&offset=20&limit=20"
}

GET /pipelines/{pipelineId}/suspected-hccs

Retrieves a list of suspected HCCs.

Parameters

Parameter In Type Required Default Description Accepted Values
pipelineId path string true N/A The identifier of the HCC pipeline. -
patientId query string true N/A The identifier of the patient within the population. -
includeSuppressed query string false N/A

Determines whether suspected HCC suppression is considered when filtering suspected HCCs in the response. A suspected HCC will be suppressed when someone has proactively disputed the validity of the suspected HCC for the patient in context.

true, false
offset query integer(int32) false 0 The number of results to skip from the beginning of the list of results (typically for the purpose of paging). The minimum offset is 0. There is no maximum offset. -
limit query integer(int32) false 20 The maximum number of results to display per page. The minimum limit is 1. The maximum limit is 100. -
orderBy query string false stratification A comma-separated list of fields by which to sort. stratification, -stratification

Response Statuses

Status Meaning Description Schema
200 OK A collection of suspected HCC objects. SuspectedHccs
400 Bad Request Bad Request Error
401 Unauthorized Unauthorized Error
403 Forbidden Forbidden Error
404 Not Found Resource not found Error

Schema Definitions

ConditionCategoryCodes

Name Type Required Description Accepted Values
items [ConditionCategoryCode] true No description -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

ConditionCategoryCode

Name Type Required Description Accepted Values
hierarchicalConditionCategory HierarchicalConditionCategoryReference true The HCC. -
code Code true The standard code that is part of a condition category. -

HierarchicalConditionCategoryReference

Name Type Required Description Accepted Values
id string true The ID of the HCC. -

Code

Name Type Required Description Accepted Values
code string false The unique identifier of the code. -
display string false A human-readable representation of the code. -
system string false The identifier of the coding system that gives meaning to the code. -

Error

Name Type Required Description Accepted Values
code integer(int32) true Http response status code representing the error. -
message string true Human readable description of the error. -
errorDetails [ErrorDetail] false List of additional error details. -

ErrorDetail

Name Type Required Description Accepted Values
domain string false A subsystem or context where an error occurred. -
reason string false Codified value representing the specific error resulting in the current error status. -
message string false Human readable description of an error. -
locationType string false Location or type of the field that caused an error. query, header, path, formData, body
location string false Name of the field that caused an error. -

HierarchicalConditionCategories

Name Type Required Description Accepted Values
items [HierarchicalConditionCategory] true [Retrieves a single HCC.] -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

HierarchicalConditionCategory

Name Type Required Description Accepted Values
id string true The ID of the HCC. -
riskAdjustmentModel RiskAdjustmentModelReference true The HCC risk adjustment model specification that this HCC is defined for. -
categoryNumber integer(int32) true The number used to uniquely represent a condition category within a risk adjustment model. -
name string true The user-friendly name for the HCC specific to the risk adjustment model. -
concept ConceptReference true The ontology concept that is used to identify the diagnosis codes that make up this HCC. -
hierarchy [string] false The ordered list of HCC IDs that form the trumping hierarchy. -
createdAt string(date-time) true The International Organization for Standardization (ISO) 8601 date and time when the HCC was created. -
updatedAt string(date-time) true The ISO 8601 date and time when the HCC was updated. -

RiskAdjustmentModelReference

Name Type Required Description Accepted Values
id string true The ID of the risk adjustment model. -

ConceptReference

Name Type Required Description Accepted Values
contextId string true The ID of the context. -
name string false A human-readable description of the concept. -
alias string true The string that is unique in the scope of a context that identifies this concept. -

RiskAdjustmentModels

Name Type Required Description Accepted Values
items [RiskAdjustmentModel] true [Retrieves a single risk adjustment model.] -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

RiskAdjustmentModel

Name Type Required Description Accepted Values
id string true The ID of the risk adjustment model. -
type string true

The type of HCC risk adjustment model, which includes the following:

  • CMS-HCC - The Centers for Medicare & Medicaid Services’ (CMS) HCC risk adjustment model.
  • HHS-HCC - The U.S. Department of Health & Human Services (HHS) HCC risk adjustment model.
CMS-HCC, HHS-HCC
name string true The user-friendly name for the risk adjustment model. -
version string true The version of the risk adjustment model’s specification. -
year integer(int32) true The year that is the target of the risk adjustment model’s specification. -
createdAt string(date-time) true The International Organization for Standardization (ISO) 8601 date and time when the risk adjustment model was created. -
updatedAt string(date-time) true The ISO 8601 date and time when the risk adjustment model was updated. -

PersistentHccs

Name Type Required Description Accepted Values
items [PersistentHcc] true No description -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

PersistentHcc

Name Type Required Description Accepted Values
patient PatientReference true The patient associated with the persistent HCC. -
hierarchicalConditionCategory HierarchicalConditionCategoryReference true The HCC that the persistent HCC is based upon. -
status string true

The status of the persistence of the HCC outcome. This status field provides a summary of the documentation of conditions categorized in an HCC for the current year.

  • PENDING - The condition was documented in a previous year (up to two years plus elapsed time in current year) and has not yet been documented this year.
  • SATISFIED - The condition has been documented in the current year.
PENDING, SATISFIED
pastPeriodSupportingData [PersistentConditionSupport] true The supporting data that indicates an HCC was documented in the previous period. -
currentPeriodSupportingData [PersistentConditionSupport] false The supporting data that indicates an HCC was documented in the current period. -
pipeline HccPipelineReference true The HCC pipeline that generated this persistent HCC outcome. -

PatientReference

Name Type Required Description Accepted Values
id string true The ID of the patient within the population. -
population PopulationReference true The population that this patient belongs to. -

PopulationReference

Name Type Required Description Accepted Values
id string true The ID of the population. -

PersistentConditionSupport

Name Type Required Description Accepted Values
condition ConditionReference true The condition that was used as support for the identification of an HCC. -
effectiveDate string false The effective date of the condition used for determining the qualifying period. For conditions that are linked to encounters, the encounter service date is used as the effective date. For conditions that are not linked to encounters, the condition onset date is used for the effective date. In ISO 8601 formatting with precision ranging from YYYY to YYYY-MM-DDThh:mm:ss.SSSZ. -

ConditionReference

Name Type Required Description Accepted Values
id string true The unique ID of the condition record. This ID can be used to retrieve details of the condition from the HealtheIntent Condition API. -

HccPipelineReference

Name Type Required Description Accepted Values
id string true The ID of the HCC pipeline. -

postPipelines

Name Type Required Description Accepted Values
createdBy object true A representation of the individual who entered the pipeline into the system. -
» id string true The unique identifier for the individual who entered the pipeline into the system. -
name string true The name of the HCC pipeline. -

HccPipeline

Name Type Required Description Accepted Values
id string true The ID of the HCC pipeline. -
name string true The name of the HCC pipeline. -
createdAt string false The date and time when the pipeline was initially entered into the system. In ISO 8601 formatting with precision to YYYY-MM-DDThh:mm:ss.SSSZ, such as 2018-02-13T20:41:18.181Z. The time is set automatically when the pipeline is first created. Therefore, the field does not need to be set explicitly. -
createdBy object false The ID of the individual who entered the pipeline into the system. -
» id string false No description -

HccPipelines

Name Type Required Description Accepted Values
items [HccPipeline] true [Retrieves a single pipeline.] -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

postPipelinesPipelineidPatientsPatientidSuspectedHccSuppressions

Name Type Required Description Accepted Values
comment string false The reason why the suppression is necessary. Maximum length of 256 characters. -
endEffective string(date-time) false The ISO 8601 date-time when the suspected HCC suppression is no longer effective. Precision will be down to the millisecond YYYY-MM-DDTHH:mm:ss.sssZ -
hierarchicalConditionCategory object true The HCC that the suspected HCC is based upon. -
» id string true The unique identifier for the hierarchical condition category. -
suppressionReason object true The reason why the suppression is necessary. -
» id string true The unique identifier for the suppression reason. -
createdBy object false A representation of the individual who entered the suppression into the system. -
» id string false No description -

SuspectedHccSuppression

Name Type Required Description Accepted Values
id string false The ID of the suspected HCC suppression. -
patient PatientReference false The patient associated with the suspected HCC. -
hierarchicalConditionCategory HierarchicalConditionCategoryReference false The HCC that the suspected HCC is based upon. -
suppressionReason SuppressionReasonReference false The reason why the suppression is necessary. -
comment string false The free-text comment describing why the suppression is necessary. The maximum length is 256 characters. -
endEffective string(date-time) false The date and time when the suspected HCC suppression is no longer effective. In ISO 8601 formatting with precision down to the millisecond (YYYY-MM-DDTHH:mm:ss.sssZ). -
pipeline HccPipelineReference true The HCC pipeline that uses this suppression to alter outcomes handling. -
createdAt string false The date and time when the suppression was initially entered into the system. In ISO 8601 formatting with precision down to the millisecond (YYYY-MM-DDTHH:mm:ss.sssZ), for example, 2018-02-13T20:41:18.181Z. The time in this field is set automatically when the suppression is first created; therefore, the field does not need to be set explicitly. -
createdBy PersonnelReference false The individual who entered the suppression into the system. -
updatedAt string false The date and time when the suppression was last modified. In ISO 8601 formatting with precision down to the millisecond (YYYY-MM-DDTHH:mm:ss.sssZ), for example, 2018-02-13T20:41:18.181Z. The time in this field is set automatically every time the suppression is modified; therefore, the field does not need to be set explicitly. When the suppression is first created, the value of the updatedAt field is set by the service and matches the value in the createdAt field. -
updatedBy PersonnelReference false The individual who last modified the suppression in the system. When the suppression is first created, the value in the updatedBy field is set by the service and matches the createdBy field. -

SuppressionReasonReference

Name Type Required Description Accepted Values
id string true The ID of the suppression reason. -

PersonnelReference

Name Type Required Description Accepted Values
id string true The ID of the personnel within the tenant. -

SuspectedHccSuppressions

Name Type Required Description Accepted Values
items [SuspectedHccSuppression] true [Retrieves a single suspected HCC suppression.] -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

putPipelinesPipelineidPatientsPatientidSuspectedHccSuppressions

Name Type Required Description Accepted Values
comment string false The reason why the suppression is necessary. Maximum length of 256 characters. -
endEffective string(date-time) false The ISO 8601 date-time when the suspected HCC suppression is no longer effective. Precision will be down to the millisecond YYYY-MM-DDTHH:mm:ss.sssZ -
hierarchicalConditionCategory object true The HCC that the suspected HCC is based upon. -
» id string true The unique identifier for the hierarchical condition category. -
suppressionReason object true The reason why the suppression is necessary. -
» id string true The unique identifier for the suppression reason. -
updatedBy object false A representation of the individual who last modified the suppression within the system. -
» id string false No description -

SuspectedHccs

Name Type Required Description Accepted Values
items [SuspectedHcc] true No description -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

SuspectedHcc

Name Type Required Description Accepted Values
patient PatientReference true The patient associated with the suspected HCC. -
hierarchicalConditionCategory HierarchicalConditionCategoryReference true The HCC that the suspected HCC is based upon. -
stratification string true

Indicates the confidence in the suspected HCC recommendation using the following stratification values:

  • HIGH - The stratification value representing the highest level of confidence based on the strength of the identified supporting data.
  • MODERATE - The stratification value representing a moderate level of confidence based on the strength of the identified supporting data.
  • NONE - The stratification value representing the lack of any supporting data to suggest the HCC in context.
HIGH, MODERATE, NONE
supportingData [SuspectedHccCovariate] false The covariate variables that support the positive identification of the suspected HCC. -
competingData [SuspectedHccCovariate] false The covariate variables that dispute the positive identification of the suspected HCC. -
suppressed boolean false True if the suspected HCC has been suppressed and false otherwise. -
suppression SuspectedHccSuppressionReference false The suppression that has been created based on feedback from a user. -
pipeline HccPipelineReference true The HCC pipeline that generated this suspected HCC outcome. -

SuspectedHccCovariate

Name Type Required Description Accepted Values
name string true The display name for the covariate. A covariate represents an independent variable value used in the suspected HCC algorithm. -
textValue string false Text value -
serviceDate string false

The service date of the clinical data point used for this covariate. In ISO 8601 formatting with precision ranging from YYYY to YYYY-MM-DDThh:mm:ss.SSSZ. The following clinical data types define how this date is populated:

  • CONDITION - The onset date.
  • CLAIM - Either the service from and to date or statement from and to date, depending on which of the fields is populated.
  • PROCEDURE - The service start date if present; otherwise, the service end date.
  • RESULT - The service date if present; otherwise, the last updated date.
  • MEDICATION - The start date.
-

SuspectedHccSuppressionReference

Name Type Required Description Accepted Values
id string true The ID of the suspected HCC suppression. -

postSuppressionReasons

Name Type Required Description Accepted Values
createdBy object false A representation of the individual who entered the suppression into the system. -
» id string true The unique identifier for the individual who entered the suppression reason into the system. -
display string true Display value of reason. Maximum length of 256 characters. -

SuppressionReason

Name Type Required Description Accepted Values
id string false The ID of the suppression reason. -
display string false The display value of the suppression reason. The maximum length is 256 characters. -
status string true The status of the suppression reason. ACTIVE, INACTIVE
createdAt string false The date and time when the suppression reason was initially entered into the system. In ISO 8601 formatting with precision down to the millisecond (YYYY-MM-DDTHH:mm:ss.sssZ), for example, 2018-02-13T20:41:18.181Z. The time in this field is set automatically when the suppression reason is first created; therefore, the field does not need to be set explicitly. -
createdBy PersonnelReference false The individual who entered the suppression reason into the system. -
updatedAt string false The date and time when the suppression reason was last modified. In ISO 8601 formatting with precision down to the millisecond (YYYY-MM-DDTHH:mm:ss.sssZ), for example, 2018-02-13T20:41:18.181Z. The time in this field is set automatically every time the suppression reason is modified; therefore, the field does not need to be set explicitly. When the suppression reason is first created, the value of the updatedAt field is set by the service and matches the value in the createdAt field. -
updatedBy PersonnelReference false The individual who last modified the suppression in the system. When the suppression reason is first created, the value in the updatedBy field is set by the service and matches the createdBy field. -

SuppressionReasons

Name Type Required Description Accepted Values
items [SuppressionReason] true [Retrieves a single suppression reason.] -
totalResults integer(int32) false The total number of results for the specified parameters. -
firstLink string true The first page of results. -
lastLink string false The last page of results. -
prevLink string false The previous page of results. -
nextLink string false The next page of results. -

putSuppressionReasons

Name Type Required Description Accepted Values
updatedBy object false A representation of the individual who entered the suppression into the system. -
» id string true The unique identifier for the individual who entered the suppression reason into the system. -
display string true Display value of reason. Maximum length of 256 characters. -
active string true The status of the suppression reason. Allowable values are ACTIVE and INACTIVE. ACTIVE, INACTIVE