HCCRiskScoreRequestPatient

Risk adjustment score is based on patient demographics and the collection of diagnosis codes used for claims. Demographics: Age, Gender, Not dual eligible or Dual eligible for Medicare and Medicaid, Medicaid full or partial benefit, On Medicare due to age or disability, Living in the community (home) or an institution (nursing home, and etc.) ICD-10 diagnosis codes are grouped into HCCs to measure disease risk factor and measure disease interactions.

Name	Description	Type	Additional information
requestId	This field has been changed to optional to meet the HIPAA De-Identification requirements. The order the requests are received is the same as the order the responses come back. Unique request ID may be assigned by client for re-identification. Following the HIPAA Privacy Rule $164.514(c) re-identification implementation specification, (Derivation) The code or other means of record identification is not derived from or related to information about the individual and is not otherwise capable of being translated so as to identify the individual; and (Security) The covered entity does not use or disclose the code or other means of record identification for any other purpose, and does not disclose the mechanism for re-identification. Globally Unique Identifier (GUID) may be used as one-time re-identification request ID. You will see an error message if there are duplicate request IDs in the request.	string	None.
age	The age of patient at the payment date. (Age = Payment Date - Date of Birth). Date of birth (in 'yyyy-MM-dd' format) is no longer used for de-identification and age is used instead. Following the HIPAA Privacy Rule $164.514(b)(2), all elements of dates (except year) for dates directly related to an individual should be removed for de-identification.	integer	Required Range: inclusive between 0 and 150
gender	Patient gender (either Male or Female)	Gender	Required
enrollee	Medicare enroll status (ContinuingEnrollee or NewEnrollee).	EnrolleeStatus	Required
model	Risk adjustment model to be used for HCC risk score calculation.	HCCRiskAdjustmentModel	Required
segment	Risk factor segment (Community or Institutional). Beneficiary lives in an institution (> 90 days) or a community.	RiskFactorSegment	Required
medicaid	Patient meidcaid benefit status (either Full, Partial, or None)	MedicaidBenefits	Required
eligibility	Current Medicare eligibility due to Aged, Disabled, ESRD, or DisabledESRD.	MedicareEligibility	Required
income	Income status ('LowIncome' or 'NonLowIncome') only for RxHCC (Part D) model. // The Part D model includes incremental factors for beneficiaries who are low-income subsidy (LIS) eligible or long term institutional (LTI).	IncomeStatus	Required
kidney	Current Kidney failure due to (Dialysis or Transplant) only for ESRD model. If the person is currently on Dialysis, or has a transplant (functioning graft)	KidneyFailure	Required
graft	Months since graft. Functioning Graft (Transplant) add-on factors only for ESRD Transplant model.	MonthsSinceGraft	Required
disabled	Boolean indicator whether originally became entitled to Medicare as disabled or not. Only for beneficiaries 65 years of age or older who were originally entitled to Medicare due to disability. Original Reason for Entitlement results in the inclusion of a factor in the risk score for beneficiaries 65 years of age or older who were originally entitled to Medicare due to disability; the factor differs by the age and sex of the beneficiary.	boolean	Required
codes	Collection of diagnosis codes used for Medicare claims/encounters	Collection of string	Required