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Found 9 Skills
Reason about clinical data terminology standards — MedDRA hierarchy (LLT→PT→HLT→HLGT→SOC), ICD-10 code structure and grouping, SNOMED CT concept model, LOINC panel relationships, and mapping decisions between systems. Use when the user asks to code adverse events, map diagnoses to ICD-10, choose a coding granularity level, group AEs by SOC or PT, interpret SNOMED CT relationships, select LOINC codes for lab panels, convert between terminology systems, or decide when to aggregate at HLT vs PT level. Triggers include "MedDRA coding", "ICD-10 grouping", "SNOMED CT", "LOINC panel", "adverse event coding", "terminology mapping", "SOC table", "preferred term", "code hierarchy", "clinical coding", "AE frequency table", "diagnosis grouping", "lab code selection", "cross-walk between terminologies".
Pipeline skill for CMS-HCC risk adjustment calculation and coding gap identification. Use when the user asks to apply the ICD-10-to-HCC crosswalk, calculate RAF scores, resolve disease hierarchies programmatically, identify coding gaps from Rx or lab proxies, project member-level risk scores, build a risk adjustment data pipeline, compute HCC coefficients, run hierarchy resolution code, or generate member risk score reports. Triggers include "calculate RAF score", "ICD-10 to HCC crosswalk", "hierarchy resolution code", "coding gap detection", "Rx proxy gap", "lab proxy gap", "risk score projection", "HCC pipeline", "member risk report", "risk adjustment Python", "risk adjustment SQL", "RAF calculation code", "CMS-HCC pipeline".
Reasoning skill for CMS-HCC risk adjustment strategy and methodology. Use when the user asks about CMS-HCC model versions V24 or V28, blended transition methodology, ICD-10-to-HCC mapping logic, disease interaction hierarchies, RAF score methodology, risk adjustment factor calculation, coding gap identification, audit-defensible documentation, HCC recapture strategy, prospective vs retrospective risk adjustment, or Medicare Advantage risk scoring. Triggers include "CMS-HCC", "V24", "V28", "blended transition", "HCC mapping", "disease hierarchy", "RAF score", "risk adjustment", "coding gap", "HCC recapture", "chart review", "audit defensible", "risk score methodology", "Medicare Advantage risk", "capitation revenue", "hierarchical condition category".
Extract billable ICD-10-CM diagnosis codes from a clinical note the way a professional coder builds the claim. Use when users say "code this encounter", "assign ICD-10 codes", "what diagnosis codes apply", "code this chart", or when turning clinical documentation into claim-ready diagnosis codes.
Pipeline skill for healthcare claims data parsing, analysis, and fraud detection. Use when the user asks to parse X12 837 or 835 claim files, manipulate ICD-10 CPT or HCPCS codes, detect billing pattern anomalies, profile providers against specialty peers, identify outlier billing behavior, validate NCCI edits programmatically, detect duplicate claims, run Benford's law analysis on charges, build claims data pipelines, or analyze E&M code distributions. Triggers include "parse X12 837", "parse 835", "claims SQL", "ICD-10 manipulation", "CPT code analysis", "provider profiling", "billing outlier", "NCCI validation code", "duplicate claim detection", "Benford's law charges", "claims ETL", "E&M distribution analysis", "claims analytics pipeline".
Real-world data cohort analysis pipeline for claims and EHR data — cohort identification with ICD-10, NDC, and CPT codes, medication adherence metrics (PDC/MPR), propensity score estimation and balance diagnostics, Kaplan-Meier survival curves, and Cox proportional hazards models. Use when the user mentions claims data, cohort identification, ICD-10 codes, NDC codes, CPT codes, medication adherence, PDC, MPR, propensity score, SMD balance, Kaplan-Meier, Cox model, Schoenfeld residuals, survival analysis on claims, or real-world evidence pipeline.
Build clinically meaningful ValueSets using the property filter system of each code system: SNOMED CT (attribute relationships + hierarchy), LOINC (CLASS/CLASSTYPE/STATUS/ORDER_OBS), RxNorm (TTY + ingredient relationships), ICD-10-CM (parent hierarchy), and UCUM (physical quantity). Use when the user wants to define a ValueSet by clinical criteria rather than enumerating codes manually, or when they ask "give me all X codes" for a code system.
FHIR API development guide for building healthcare endpoints. Use when: (1) Creating FHIR REST endpoints (Patient, Observation, Encounter, Condition, MedicationRequest), (2) Validating FHIR resources and returning proper HTTP status codes and error responses, (3) Implementing SMART on FHIR authorization and OAuth scopes, (4) Working with Bundles, transactions, batch operations, or search pagination. Covers FHIR R4 resource structures, required fields, value sets (status codes, gender, intent), coding systems (LOINC, SNOMED, RxNorm, ICD-10), and OperationOutcome error handling.
Map a code from any clinical terminology (ICD-10-CM, LOINC, RxNorm) to its SNOMED CT equivalent in order to unlock SNOMED's rich semantic attribute relationships. Use when the user has a code in a non-SNOMED system and wants to explore related concepts, find clinically adjacent codes, understand the semantic meaning, or build a SNOMED-based ValueSet from a non-SNOMED starting point. Always propose this when a user asks about relationships or "what is related to X" and the code is not already in SNOMED.