Arkansas Health Care Payment Improvement Initiative Asthma Algorithm Summary
|
|
- John Woods
- 5 years ago
- Views:
Transcription
1 Arkansas Health Care Payment Improvement Initiative Asthma Algorithm Summary
2 Asthma Algorithm Summary v1.6 Page 2 of 15 Triggers An episode is triggered when a patient shows an inpatient or emergency room claims with Asthma diagnosis code or DRG codes. For specific ICD-9-CM and DRG, please see datasets. PAP Assignment Exclusions Episode Time Window The Principal Accountable Provider (PAP) for an episode is the facility enrolled in an Arkansas Blue Plan provider network that admits the patient with trigger diagnosis codes. Episodes meeting one or more of the following criteria will be excluded: A. The patient has claims or enrollment records that indicate coordination of benefits with another payer not associated with the Arkansas Blue Plans within the duration of the episode B. The patient does not have continuous coverage with at least one Arkansas Blue Plan throughout the entire episode C. The overall episode cost for the patient exceeds the outlier criteria. Currently, the outlier threshold is set at three standard deviations above the average episode cost for all patients otherwise included in the reporting period for all PAPs D. The episode window overlaps with another episode E. Procedure occurred late in the performance period, episode will likely appear on next report F. Provider terminated prior to report publication G. The patient was discharged against medical advice or due to expiration. H. Patient less than 5 years old I. Patient claims indicate one of the following co-morbidities within 365 days before or within the episode: 1) Abortion complications, 2) Complications from organ transplants, 3) Dialysis, 4) HIV, 5) Head/Neck cancer, 6) Breast cancer 7) Cervix cancer, 8) Leukemias, 9) Poison (non-medical), 10) ESRD (End-Stage Renal Disease), 11) Perinatal jaundice, 12) Respiratory distress, 13) Prostate cancer, 14) Bone cancer, 15) Brain cancer, 16) Bronchial/lung cancer, 17) Colon cancer, 18) Esophageal cancer, 19) GI/peritoneum cancer, 20) Liver cancer, 21) Malignant neoplasm, 22) Neoplasm unspecified, 23) Female genital cancer, 24) Male genital cancer, 25) Ovarian cancer, 26) Pancreas cancer, 27) Rectum/anus cancer, 28) Kidney/renal cancer, 29) Stomach cancer, 30) Urinary organ cancer, 31) Secondary malignancy, 32) Other respiratory cancer, 33) Other primary cancer, 34) Fetal disturbances, 35) Forceps or vacuum extractor delivery, 36) Malposition, 37) Other perinatal diagnosis, 38) Umbilical cord complications, 39) Spontaneous abortion, 40) Suicide and intentional self-inflicted injury, 41) Bladder cancer, 42) Uterus cancer, 43) Thyroid cancer, 44) Testicle cancer, 45) Skin melanoma, 46) Pelvic obstruction, 47) Hodgkin s lymphoma, 48) Non-Hodgkin s lymphoma, 49) Multiple myeloma, 50) Polyarteritis nodosa, 51) Arteritis NOS, 52)Amnios, 53) Louse-borne typhus, 54) Maintenance chemical J. Patient is an Exchange member K. Patient is an Access Only member L. Non-par self-insured groups: ABB/Baldor, Greenbay Packaging, Hytrol, Nabholz, Navistar, Nucor, Replacement Parts, Riceland, Southern Steel and Wire The episode begins when the patient enters the emergency room or is admitted to an inpatient facility for a diagnosis of Asthma, and ends 30 days after the patient is discharged from the facility.
3 Asthma Algorithm Summary v1.6 Page 3 of 15 Claims Included Quality Measures Utilization Measures Adjustments Trigger Codes The following claims are included if incurred within the episode: A. Inpatient facility claims for admit date within 30 days after the trigger procedure, even if discharge is after 30 days. Claims with a DRG on the CMS list of exclusions for respiratory conditions will not be included in the episode. B. Include all claims in the episode window identified by the ETG for Asthma. C. Include all claims in the episode window related to the specific Asthma procedures as defined in the diagnosis, DRG, procedure code, and NDC lists for the entire window unless otherwise listed in the codes excluded in the attached datasets. Quality measures to pass (payment related): A. Percent of episodes where patient visits an outpatient physician within 30 days after initial discharge. Visits are identified as evaluation and management procedure codes that are performed in provider s office, patient s home, or a rural health clinic, by specialists in the following list: general practice, family practice, internal medicine, pediatric medicine, geriatric medicine, primary-care nurse practitioners, primary-care physician assistant, or pulmonary medicine. To satisfy this measure the rate must be equal to or greater than 50%. B. This is the number of eligible episodes flagged with Corticosteroid prescriptions filled 30 days before or after initial trigger, divided by the total number of eligible episodes for a provider. To satisfy this measure the rate must be equal to or greater than 50%. Quality measures to track (not payment related): A. Rate of repeat acute exacerbation within 30 days after initial discharge. Acute exacerbation is a potential trigger within the episode. This is the number of eligible episodes with an acute exacerbation, divided by the total number of eligible episodes for a provider. To satisfy this measure the rate must be equal to or greater than 50%. Utilization measures to track (not payment related): A. Average rate of inpatient admission. This is the number of eligible episodes flagged inpatient, divided by the total number of eligible episodes for a provider. B. Average length of stay for inpatient admissions. This is the average number of days from the trigger date through the end of the inpatient stay. The total reimbursements attributed to the PAP will be adjusted based on complications that resulted in variations in treatment using a multiplier determined by regression. Over time, risk factors may be added or subtracted based on new research and/or empirical evidence. Claims with the following DRG codes for inpatient visits are considered when triggering an Asthma episode: DRG codes: 0202, 0203 Claims with the following diagnosis codes and Revenue codes for emergency room visits are considered when triggering an Asthma episode (see below dataset): ICD-9 Diagnosis codes: , , , , , , 493.2, , , , 493.8, , , , , , DRG Codes: 0450, 0451, 0452, 0456, 0459
4 Asthma Algorithm Summary v1.6 Page 4 of 15 Trigger Codes Codes Claims that occur within 365 days after one of the diagnosis codes listed above with the following diagnosis codes and Revenue codes for emergency room visits are considered when triggering an Asthma episode (see below dataset): Diagnosis codes: , , , , Revenue Codes: 0450, 0451, 0452, 0456, 0459 Please see the final pages of this document for a list of the corresponding ICD-10 codes Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-9-CM codes: , 150.0, 150.1, 150.2, 150.3, 150.4, 150.5, 150.8, 150.9, 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9, 152.0, 152.1, 152.2, 152.3, 152.8, 152.9, 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 154.2, 154.3, 154.8, 155.0, 155.1, 155.2, 156, 156.0, 156.0, 156.1, 156.1, 156.2, 156.2, 156.8, 156.8, 156.9, 156.9, 157.0, 157.1, 157.2, 157.3, 157.4, 157.8, 157.9, 158.0, 158.8, 158.9, 159.0, 159.1, 159.8, 159.9, 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 163.0, 163.1, 163.8, 163.9, 164.0, 164.1, 164.2, 164.3, 164.8, 164.9, 165.0, 165.8, 165.9, 170.0, 170.1, 170.2, 170.3, 170.4, 170.5, 170.6, 170.7, 170.8, 170.9, 171.0, 171.2, 171.3, 171.4, 171.5, 171.6, 171.7, 171.8, 171.9, 176.0, 176.1, 176.2, 176.3, 176.4, 176.5, 176.8, 176.9, 181, 181., 183.0, 183.2, 183.3, 183.4, 183.5, 183.8, 183.9, 184.0, 184.1, 184.2, 184.3, 184.4, 184.8, 184.9, 187.1, 187.2, 187.3, 187.4, 187.5, 187.6, 187.7, 187.8, 187.9, 189.0, 189.1, 189.2, 189.3, 189.4, 189.8, 189.9, 190.0, 190.1, 190.2, 190.3, 190.4, 190.5, 190.6, 190.7, 190.8, 190.9, 191.0, 191.1, 191.2, 191.3, 191.4, 191.5, 191.6, 191.7, 191.8, 191.9, 192.0, 192.1, 192.2, 192.3, 192.8, 192.9, 194.0, 194.1, 194.3, 194.4, 194.5, 194.6, 194.8, 194.9, 195.1, 195.2, 195.3, 195.4, 195.5, 195.8, 196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9, 197.0, 197.1, 197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198.0, 198.1, 198.2, 198.3, 198.4, 198.5, 198.6, 198.7, , , , 199.0, 199.1, 199.2, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 230.1, 230.2, 230.3, 230.4, 230.5, 230.6, 230.7, 230.8, 230.9, 231.1, 231.2, 231.8, 231.9, 233.3, , , , , 233.5, 233.6, 233.9, 234.0, 234.8, 234.9, 235.0, 235.1, 235.2, 235.3, 235.4, 235.5, 235.6, 235.7, 235.8, 235.9, 236.0, 236.1, 236.2, 236.3, 236.4, 236.5, 236.6, 236.7, , , , 237.0, 237.1, 237.2, 237.3, 237.4, 237.5, 237.6, 237.7, , , , , , 237.9, 238.0, 238.1, 238.2, 238.3, 238.4, 238.5, 238.6, 238.7, , , , , , , , , 238.8, 238.9, 239.0, 239.1, 239.2, 239.3, 239.4, 239.5, 239.6, 239.7, 239.8, , , Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-9-CM codes: , , , , 443.2, , , , 494.5, , 555, 555., 555.0, 555.1, 555.2, 555.9, 556, 556., 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 585.5, 585.6, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 638.0, 638.1, 638.2, 638.3, 638.4, 638.5, 638.6, 638.7, 638.8, 638.9, 639.0, 639.1, 639.2, 639.3, 639.4, 639.5, 639.6, 639.8, 639.9, , , , , , , , , ,
5 Asthma Algorithm Summary v1.6 Page 5 of 15 Codes ICD-9-CM codes: , , , , , , , , , , , , , , , , , , , , , ,656.31, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 760.0, 760.1, 760.2, 760.3, 760.4, 760.5, 760.6, , , , , , , , , , , 760.8, 760.9, 761.0, 761.1, 761.2, 761.3, 761.4, 761.5, 761.6, 761.7, 761.8, 761.9, 762.0, 762.1, 762.2, 762.3, 762.4, 762.5, 762.6, 762.7, 762.8, 762.9, 763.0, 763.1, 763.2, 763.3, 763.4, 763.5, 763.6, 763.7, 763.8, , , , , , 763.9, 766.0, 766.1, 766.2, , , 769, 769., 770.0, 770.1, , , , , , , , , , 770.2, 770.3, 770.4, 770.5, 770.6, 770.7, 770.8, , , , , , , , , 770.9, 771.0, 771.1, 771.2, 771.3, 771.4, 771.5, 771.6, 771.7, 771.8, , , , 772.0, 772.1, , , , , , 772.2, 772.3, 772.4, 772.5, 772.6, 772.8, 772.9, 773.0, 773.1, 773.2, 773.3, 773.4, 773.5, 774.0, 774.1, 774.2, , , , 774.4, 774.5, 774.6, 774.7, 775.0, 775.1, 775.2, 775.3, 775.4, 775.5, 775.6, 775.7, 775.8, , , 775.9, 776.0, 776.1, 776.2, 776.3, 776.4, 776.5, 776.6, 776.7, 776.8, 776.9, 777.1, 777.2, 777.3, 777.4, 777.5, , , , , 777.6, 777.8, 777.9, 778.0, 778.1, 778.2, 778.3, 778.4, 778.5, 778.6, 778.7, 778.8, 778.9, 779.0, 779.1, 779.2, 779.3, , , , , 779.4, 779.6, 779.7, 779.8, , , , , , 779.9, , , , 789.7, 795.1, , , , , , , , , , , , , 996.8, E95.00, E95.01, E95.02, E95.03 Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-9-CM codes: E95.04, E95.05, E95.06, E95.07, E95.08, E95.09, E95.10, E95.11, E95.18, E95.20, E95.21, E95.28, E95.29, E95.30, E95.31, E95.38, E95.39, E95.4, E95.50, E95.51, E95.52, E95.53, E95.54, E95.55, E95.56, E95.57, E95.59, E95.6, E95.70, E95.71, E95.72, E95.79, E95.80, E95.81, E95.82, E95.83, E95.84, E95.85, E95.86, E95.87, E95.88, E95.89, E95.9, V10.00, V10.03, V10.04, V10.05, V10.06, V10.07, V10.09, V10.11, V10.12, V10.20, V10.22, V10.29, V10.40, V10.43, V10.44, V10.45, V10.48, V10.49, V10.50, V10.52, V10.53, V10.59, V10.81, V10.84, V10.85, V10.86, V10.88, V10.89, V10.9, V10.90, V10.91, V13.7, V42.0, V42.0, V42.1, V42.5, V42.7, V45.1, V45.1, V45.11, V45.12, V50.2, V55.2, V55.3, V56., V56.0, V56.1, V56.2, V56.3, V56.31, V56.32, V56.8 Claims with the following CPT/HCPCS procedure codes will be excluded: Procedure codes: 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 71250, 71260, 71270, 71275, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72191, 72192, 72193, 72194, 73200, 73201, 73202, 73206, 73700, 73701, 73702, 73706, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74261, 74262, 74263, 75571, 75572, 75573, 75574, 75635, 76380, 76497, 77011, 77012, 77013, 77014, 77078, 81001, 81003, 82550, 82553, 82784, 82785, 82947, 83690, 83880, 84450, 85651, 85810, 86140, 93306, 95811, A0425, J2250, J2550, J3010
6 Asthma Algorithm Summary v1.6 Page 6 of 15 Codes Claims with the following DRG codes are excluded based on the CMS exclusions for respiratory conditions: MS-DRG codes: 0001, 0002, 0005, 0006, 0007, 0008, 0010, 0011, 0012, 0013, 0014, 0016, 0017, 0020, 0021, 0022, 0023, 0024, 0025, 0026, 0027, 0028, 0029, 0030, 0031, 0032, 0033, 0034, 0035, 0036, 0037, 0038, 0039, 0040, 0041, 0042, 0113, 0114, 0115, 0116, 0117, 0129, 0130, 0131, 0132, 0133, 0134, 0135, 0136, 0137, 0138, 0139, 0216, 0217, 0218, 0219, 0220, 0221, 0222, 0223, 0224, 0225, 0226, 0227, 0228, 0229, 0230, 0231, 0232, 0233, 0234, 0235, 0236, 0237, 0238, 0239, 0240, 0241, 0242, 0243, 0244, 0245, 0246, 0247, 0248, 0249, 0250, 0251, 0255, 0256, 0257, 0258, 0259, 0260, 0261, 0262, 0263, 0264, 0265, 0326, 0327, 0328, 0329, 0330, 0331, 0332, 0333, 0334, 0335, 0336, 0337, 0338, 0339, 0340, 0341, 0342, 0343, 0344, 0345, 0346, 0347, 0348, 0349, 0350, 0351, 0352, 0353, 0354, 0355, 0405, 0406, 0407, 0408, 0409, 0410, 0411, 0412, 0413, 0414, 0415, 0416, 0417, 0418, 0419, 0420, 0421, 0422, 0423, 0424, 0425, 0453, 0454, 0455, 0456, 0457, 0458, 0459, 0460, 0461, 0462, 0463, 0464, 0465, 0466, 0467, 0468, 0469, 0470, 0471, 0472, 0473, 0474, 0475, 0476, 0477, 0478, 0479, 0480, 0481, 0482, 0483, 0484, 0485, 0486, 0487, 0488, 0489, 0490, 0491, 0492, 0493, 0494, 0495, 0496, 0497, 0498, 0499, 0500, 0501, 0502, 0503, 0504, 0505, 0506, 0507, 0508, 0509, 0510, 0511, 0512, 0513, 0514, 0515, 0516, 0517, 0570, 0571, 0572, 0573, 0574, 0575, 0576, 0577, 0578, 0579, 0580, 0581, 0582, 0583, 0584, 0585, 0614, 0615, 0616, 0617, 0618, 0619, 0620, 0621, 0622, 0623, 0624, 0625, 0626, 0627, 0652, 0653, 0654, 0655, 0656, 0657, 0658, 0659, 0660, 0661, 0662, 0663,0664, 0665, 0666, 0667, 0668, 0669, 0670, 0671, 0672, 0673, 0674, 0675, 0707, 0708, 0709, 0710, 0711, 0712, 0713, 0714, 0715, 0716, 0717, 0718, 0734, 0735, 0736, 0737, 0738, 0739, 0740, 0741, 0742, 0743, 0744, 0745, 0746, 0747, 0748, 0749, 0750, 0765, 0766, 0767, 0768, 0769, 0770, 0799, 0800, 0801, 0820, 0821, 0822, 0823, 0824 Claims with the following DRG codes are excluded based on the CMS exclusions for respiratory conditions: MS-DRG codes: 0825, 0826, 0827, 0828, 0829, 0830, 0856, 0857, 0858, 0876, 0901, 0902, 0903, 0904, 0905, 0906, 0907, 0908, 0909, 0927, 0928, 0929, 0955, 0956, 0957, 0958, 0959, 0969, 0970, 0984, 0985, 0986 Claims Included Codes Please see the final pages of this document for a list of the corresponding ICD-10 codes The episode will include all claims classified with an ETG of Asthma. In addition, patients who have claims including any of the following CPT/HCPCS procedure codes and NDC codes will be included (see below dataset): Procedure codes: E0424, E0425, E0430, E0431, E0433, E0434, E0435, E0439, E0440, E0441, E0442, E0443, E0444, E1390, E1391, E1392, E1405, E1406, K0738, K0741, S8120, S8121 NDC codes: There are more than 2,100 NDC codes, can provided upon request.
7 Asthma Algorithm Summary v1.6 Page 7 of 15 Quality Codes Quality measures to pass (payment related) 30-Day Follow Up: calculated based on claims within 30 days of initial discharge. Procedure Code: 99201, 99202, 99203, 99204,99205, 99206, 99207, 99208, 99209, 99210, 99211, 99212, 99213, 99214, 99215, 99216, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99224, 99225, 99226, 99227, 99228, 99229, 99230, 99231, 99232, 99233, 99234, 99235, 99236, 99237, 99238, 99239, 99240, 99241, 99242, 99243, 99244, 99245, 99246, 99247, 99248, 99249, 99250, 99251, 99252, 99253, 99254, 99255, 99256, 99257, 99258, 99259, 99260, 99261, 99262, 99263, 99264, 99265, 99266, 99267, 99268, 99269, 99270, 99271, 99272, 99273, 99274, 99275, 99276, 99277, 99278, 99279, 99280, 99281, 99282, 99283, 99284, 99285, 99286, 99287, 99288, 99289, 99290, 99291, 99292, 99293, 99294, 99295, 99296, 99297, 99298, 99299, 99300, 99301, 99302, 99303, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99311, 99312, 99313, 99314, 99315, 99316, 99317, 99318, 99319, 99320, 99321, 99322, 99323, 99324, 99325, 99326, 99327, 99328, 99329,99330, 99331, 99332, 99333, 99334, 99335, 99336, 99337, 99338, 99339, 99340, 99341, 99342, 99343, 99344, 99345, 99346, 99347, 99348, 99349, 99350, 99351, 99352, 99353, 99354, 99355, 99356, 99357, 99358, 99359, 99360, 99361, 99362, 99363, 99364, 99365, 99366, 99367, 99368, 99369, 99370, 99371, 99372, 99373, 99374, 99375, 99376, 99377, 99378, 99379, 99380, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99388, 99389, 99390, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99398, 99399, 99400, 99401, 99402, 99403, 99404, 99405, 99406, 99407, 99408, 99409, 99410, 99411, 99412, 99413, 99414, 99415, 99416, 99417, 99418, 99419, 99420, 99421, 99422, 99423, 99424, 99425, 99426, 99427, 99428, 99429, 99430, 99431, 99432, 99433, 99434, 99435, 99436, 99437, 99438, 99439, 99440, 99441, 99442, 99443, 99444, 99445, 99446, 99447, 99448, 99449, 99450, 99451, 99452, 99453, 99454, 99455, 99456, 99457, 99458, 99459, 99460, 99461, 99462, 99463, 99464, 99465, 99466, 99467, 99468, 99469, 99470, 99471, 99472, 99473, 99474, 99475, 99476, 99477, 99478, 99479, 99480, 99481, 99482, 99483, 99484, 99485, 99486, 99487, 99488, 99489, 99490, 99491, 99492, 99493, 99494, 99495, 99496, 99497, 99498, Quality measures to track (non payment related) Repeat Exacerbation: Claims with the following DRG codes for inpatient visits are considered when triggering an Asthma episode: DRG codes: 0202, 0203 Claims that occur within 365 days after one of the diagnosis codes listed above with the following diagnosis codes and Revenue codes for emergency room visits are considered when triggering an Asthma episode: Diagnosis codes: , , , , DRG Codes: 0450, 0451, 0452, 0456, 0459 Corticosteroid: Over 700 NDCs utilized in analysis, both oral and inhalation. Detailed list is available upon request. Please see the final pages of this document for a list of the corresponding ICD-10 codes
8 Asthma Algorithm Summary v1.6 Page 8 of 15 Utilization Codes No codes for utilization. Trigger codes ICD-9 Diagnosis codes: , , , , , , 493.2, , , , 493.8, , , , , , ICD-10 Diagnosis codes: 4520, J4521, J4522, J4530, J4531, J4532, J4540, J4541, J4542, J4550, J4551, J4552, J45901, J45902, J45909, J45990, J45991, J45998, J9801 Claims that occur within 365 days after one of the diagnosis codes listed above with the following diagnosis codes and Revenue codes for emergency room visits are considered when triggering an Asthma episode (see below dataset): Diagnosis codes: , , , , Diagnosis codes: 0PP304Z, 0PP307Z, 0PP30JZ, 0PP30KZ, 0PP334Z, 0PP337Z, 0PP33JZ, 0PP33KZ, 0PP344Z, 0PP347Z, 0PP34JZ, 0PP34KZ, 0PP404Z, 0PP407Z, 0PP40JZ, 0PP40KZ, 0PP434Z, 0PP437Z, 0PP43JZ, 0PP43KZ, 0PP444Z, 0PP447Z, 0PP44JZ, 0PP44KZ, 0PPR04Z, 0PPR05Z, 0PPR07Z, 0PPR0JZ, 0PPR0KZ, 0PPR34Z, 0PPR35Z, 0PPR37Z, 0PPR3JZ, 0PPR3KZ, 0PPR44Z, 0PPR45Z, 0PPR47Z, 0PPR4JZ, 0PPR4KZ, 0PPS04Z, 0PPS05Z, 0PPS07Z, 0PPS0JZ, 0PPS0KZ, 0PPS34Z, 0PPS35Z, 0PPS37Z, 0PPS3JZ, 0PPS3KZ, 0PPS44Z, 0PPS45Z, 0PPS47Z, 0PPS4JZ, 0PPS4KZ, 0PPT04Z, 0PPT05Z, 0PPT07Z, 0PPT0JZ, 0PPT0KZ, 0PPT34Z, 0PPT35Z, 0PPT37Z, 0PPT3JZ, 0PPT3KZ, 0PPT44Z, 0PPT45Z, 0PPT47Z, 0PPT4JZ, 0PPT4KZ, 0PPV04Z, 0PPV05Z, 0PPV07Z, 0PPV0JZ, 0PPV0KZ, 0PPV34Z, 0PPV35Z, 0PPV37Z, 0PPV3JZ, 0PPV3KZ, 0PPV44Z, 0PPV45Z, 0PPV47Z, 0PPV4JZ, 0PPV4KZ, 0PPY0MZ, 0PPY3MZ, 0PPY4MZ, 0QP004Z, 0QP007Z, 0QP00JZ, 0QP00KZ, 0QP034Z, 0QP037Z, 0QP03JZ, 0QP03KZ, 0QP044Z, 0QP047Z, 0QP04JZ, 0QP04KZ, 0QP104Z, 0QP107Z, 0QP10JZ, 0QP10KZ, 0QP134Z, 0QP137Z, 0QP13JZ, 0QP13KZ, 0QP144Z, 0QP147Z, 0QP14JZ, 0QP14KZ, 0QP204Z, 0QP205Z, 0QP207Z, 0QP20JZ, 0QP20KZ, 0QP234Z, 0QP235Z, 0QP237Z, 0QP23JZ, 0QP23KZ, 0QP244Z, 0QP245Z, 0QP247Z, 0QP24JZ, 0QP24KZ, 0QP304Z, 0QP305Z, 0QP307Z, 0QP30JZ, 0QP30KZ, 0QP334Z, 0QP335Z, 0QP337Z, 0QP33JZ, 0QP33KZ, 0QP344Z, 0QP345Z, 0QP347Z, 0QP34JZ, 0QP34KZ, 0QP404Z, 0QP407Z, 0QP40JZ, 0QP40KZ, 0QP434Z, 0QP437Z, 0QP43JZ, 0QP43KZ, 0QP444Z, 0QP447Z, 0QP44JZ, 0QP44KZ, 0QP504Z, 0QP507Z, 0QP50JZ, 0QP50KZ, 0QP534Z, 0QP537Z, 0QP53JZ, 0QP53KZ, 0QP544Z, 0QP547Z, 0QP54JZ, 0QP54KZ, 0QPQ04Z, 0QPQ05Z, 0QPQ07Z, 0QPQ0JZ, 0QPQ0KZ, 0QPQ34Z, 0QPQ35Z, 0QPQ37Z, 0QPQ3JZ, 0QPQ3KZ, 0QPQ44Z, 0QPQ45Z, 0QPQ47Z, 0QPQ4JZ, 0QPQ4KZ, 0QPR04Z, 0QPR05Z, 0QPR07Z, 0QPR0JZ, 0QPR0KZ, 0QPR34Z, 0QPR35Z, 0QPR37Z, 0QPR3JZ, 0QPR3KZ, 0QPR44Z, 0QPR45Z, 0QPR47Z, 0QPR4JZ, 0QPR4KZ, 0QPS04Z, 0QPS07Z, 0QPS0JZ, 0QPS0KZ, 0QPS34Z, 0QPS37Z, 0QPS3JZ, 0QPS3KZ, 0QPS44Z, 0QPS47Z, 0QPS4JZ, 0QPS4KZ, 0QPY0MZ, 0QPY3MZ, 0QPY4MZ, R0600, R0602, R0609, R062, R0683, R0689, R069
9 Asthma Algorithm Summary v1.6 Page 9 of 15 Codes Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-10-CM codes: A4851, B20, B9735, A750, C000, C001, C003, C004, C005, C006, C008, C002, C009, C01, C020, C021, C022, C023, C024, C028, C029, C07, C080, C081, C089, C030, C031, C039, C040, C041, C048, C049, C060, C061, C050, C051, C052, C058, C059, C062, C0680, C0689, C069, C098, C099, C090, C091, C100, C101, C102, C103, C104, C108, C109, C110, C111, C112, C113, C118, C119, C130, C12, C131, C132, C138, C139, C140, C142, C148, C153, C154, C155, C158, C159, C160, C164, C163, C161, C162, C165, C166, C168, C169, C170, C171, C172, C173, C178, C179, C183, C184, C186, C187, C180, C181, C182, C185, C188, C189, C19, C20, C211, C210, C212, C218, C220, C222, C223, C224, C227, C228, C221, C229, C23, C240, C241, C248, C249, C250, C251, C252, C253, C254, C257, C258, C259, C480, C451, C481, C488, C482, C260, C261, C269, C300, C301, C310, C311, C312, C313, C318, C319, C320, C321, C322, C323, C328, C329, C33, C3400, C3401, C3402, C3410, C3411, C3412, C342, C3430, C3431, C3432, C3480, C3481, C3482, C3490, C3491, C3492, C384, C450, C37, C380, C452, C381, C382, C388, C383, C390, C399, C410, C411, C412, C413, C4000, C4001, C4002, C4010, C4011, C4012, C414, C4020, C4021, C4022, C4030, C4031, C4032, C4080, C4081, C4082, C4090, C4091, C4092, C419, C470, C490, C4710, C4711, C4712, C4910, C4911, C4912, C4720, C4721, C4722, C4920, C4921, C4922, C473, C493, C474, C494, C475, C495, C476, C496, C478, C498, C479, C499, C430, D030, C4310, C4311, C4312, D0310, D0311, D0312, C4320, C4321, C4322, D0320, D0321, D0322, C4330, C4331, C4339, D0330, D0339, C434, D034, C4351, C4352, C4359, D0351, D0352, D0359, C4360, C4361, C4362, D0360, D0361, D0362, C4370, C4371, C4372, D0370, D0371, D0372, C438, D038, C439, D039, C50011, C50012, C50019, C50111, C50112, C50119, C50211, C50212, C50219, C50311, C50312, C50319, C50411, C50412, C50419, C50511, C50512, C50519, C50611, C50612, C50619, C50811, C50812, C50819, C50911, C50912, C50919, C50021, C50022, C50029, C50121, C50122, C50129, C50221, C50222, C50229, C50321, C50322, C50329, C50421, C50422, C50429, C50521, C50522, C50529, C50621, C50622, C50629, C50821, C50822, C50829, C50921, C50922, C50929, C460, C461, C462, C464, C4650, C4651, C4652, C463, C467, C469, C55, C530, C531, C538, C539, C58, C541, C542, C543, C549, C540, C548, C561, C562, C569, C5700, C5701, C5702, C5710, C5711, C5712, C573, C5720, C5721, C5722, C574, C574, C52, C510, C511, C512, C519, C518, C577, C578, C579, C61, C6200, C6201, C6202, C6210, C6211, C6212, C6290, C6291, C6292, C600, C601, C602, C609, C6300, C6301, C6302, C6310, C6311, C6312, C632, C608, C637, C638, C639, C670, C671, C672, C673, C674, C675, C676, C677, C678, C679, C641, C642, C649, C651, C652, C659, C661, C662, C669, C680, C681, C688, C689, C6940, C6941, C6942, C6960, C6961, C6962, C6900, C6901, C6902, C6910, C6911, C6912, C6920, C6921, C6922, C6930, C6931, C6932, C6950, C6951, C6952, C6980, C6981, C6982, C6990, C6991, C6992, C710, C711, C712, C713, C714, C715, C716, C717, C718, C719, C7220, C7221, C7222, C7230, C7231, C7232, C7240, C7241, C7242, C7250, C7259, C700, C709, C720, C721, C701, C729, C73, C7400, C7401, C7402, C7410, C7411, C7412, C7490, C7491, C7492, C750, C751, C752, C753, C754, C755, C758, C759, C760, C761, C762, C763, C7640, C7641, C7642, C7650, C7651, C7652, C457, C768, C770, C771, C772, C773, C774, C775, C778, C779, C7800, C7801, C7802, C781, C782, C7830, C7839, C784, C785, C786, C787, C7880, C7889, C7900, C7901, C7902, C7910, C7911, C7919, C792, C7931, C7932, C7940, C7949, C7951, C7952, C7960, C7961, C7962, C7970, C7971, C7972, C7981, C7982, C7989, C799, C800, C459, C801, C802, C8330, C8339, C8331, C8332, C8333, C8334, C8335, C8336, C8337, C8338, C8350, C8359, C8351, C8352, C8353, C8354, C8355, C8356, C8357, C8358, C8370, C8379, C8371, C8372, C8373, C8374, C8375, C8376, C8377, C8378, C8380, C8389, C884, C8382, C8383, C8387, C8310, C8319, C8311, C8312, C8313, C8314, C8315, C8316, C8317, C8318, C8381, C8460, C8469, C8470, C8479, C8461, C8471, C8462, C8472, C8463, C8473, C8464, C8474, C8465, C8475, C8466, C8476, C8467, C8477, C8468, C8478, C8300, C8309, C8390, C8399, C865, C866, C8301, C8391, C8302, C8392, C8303, C8393, C8304, C8384, C8394, C8305, C8385, C8395, C8306, C8386, C8396, C8307, C8397, C8308, C8388, C8398, C8171, C8173, C8174, C8177, C8170, C8179, C8172, C8175, C8176, C8178, C8100, C8109, C8140, C8149, C8101, C8141, C8102, C8142, C8103, C8143, C8104, C8144, C8105, C8145, C8106, C8146, C8107, C8147, C8108, C8148, C8110, C8119, C8111, C8112, C8113, C8114, C8115, C8116, C8117, C8118, C8120, C8129, C8121, C8122, C8123, C8124, C8125, C8126, C8127, C8128, C8130, C8139, C8131, C8132, C8133, C8134, C8135, C8136,
10 Asthma Algorithm Summary v1.6 Page 10 of 15 codes ICD-10-CM codes: C8137, C8138, C8190, C8199, C8191, C8192, C8193, C8194, C8195, C8196, C8197, C8198, C8200, C8209, C8210, C8219, C8220, C8229, C8230, C8239, C8240, C8249, C8260, C8269, C8280, C8289, C8290, C8299, C8201, C8211, C8221, C8231, C8241, C8261, C8281, C8291, C8202, C8212, C8222, C8232, C8242, C8262, C8282, C8292, C8203, C8213, C8223, C8233, C8243, C8263, C8283, C8293, C8204, C8214, C8224, C8234, C8244, C8264, C8284, C8294, C8205, C8215, C8225, C8235, C8245, C8265, C8285, C8295, C8206, C8216, C8226, C8236, C8246, C8266, C8286, C8296, C8207, C8217, C8227, C8237, C8247, C8267, C8287, C8297, C8208, C8218, C8228, C8238, C8248, C8268, C8288, C8298, C8400, C8409, C8401, C8402, C8403, C8404, C8405, C8406, C8407, C8408, C8410, C8419, C8411, C8412, C8413, C8414, C8415, C8416, C8417, C8418, C96A, C9140, C9141, C9142, C960, C962, C8440, C8449, C8441, C8442, C8443, C8444, C8445, C8446, C8447, C8448, C8250, C8259, C8490, C8499, C84A0, C84A9, C84Z0, C84Z9, C8510, C8519, C8520, C8529, C8580, C8589, C8590, C8599, C864, C8251, C8491, C84A1, C84Z1, C8511, C8521, C8581, C8591, C860, C8252, C8492, C84A2, C84Z2, C8512, C8522, C8582, C8592, C8253, C8493, C84A3, C84Z3, C8513, C8523, C8583, C8593, C862, C863, C8254, C8494, C84A4, C84Z4, C8514, C8524, C8584, C8594, C8255, C8495, C84A5, C84Z5, C8515, C8525, C8585, C8595, C8256, C8496, C84A6, C84Z6, C8516, C8526, C8586, C8596, C8257, C8497, C84A7, C84Z7, C8517, C8527, C8587, C8597, C861, C8258, C8498, C84A8, C84Z8, C8518, C8528, C8588, C8598, C964, C969, C96Z, C9000, C9001, C9002, C9010, C9011, C9012, C882, C883, C889, C9020, C9030, C9021, C9031, C9022, C9032, C9100, C9101, C9102, C9110, C9111, C9112, C9130, C9150, C9160, C91A0, C91Z0, C9131, C9151, C9161, C91A1, C91Z1, C9132, C9152, C9162, C91A2, C91Z2, C9190, C9191, C9192, C9200, C9240, C9250, C9260, C92A0, C9201, C9241, C9251, C9261, C92A1, C9202, C9242, C9252, C9262, C92A2, C9210, C9211, C9212, C9220, C9221, C9222, C9230, C9231, C9232, C92Z0, C92Z1, C92Z2, C9290, C9291, C9292, C9300, C9301, C9302, C9310, C9311, C9312, C9392, C9330, C93Z0, C9331, C93Z1, C9332, C93Z2, C9390, C9391, C9400, C9401, C9402, C9420, C9421, C9422, C9430, C9480, C9431, C9481, C9432, C9482, C9500, C9501, C9502, C9510, C9511, C9512, C9590, C9591, C9592, C7A019, C7A010, C7A011, C7A012, C7A029, C7A020, C7A021, C7A022, C7A023, C7A024, C7A025, C7A026, C7A00, C7A090, C7A091, C7A092, C7A093, C7A094, C7A095, C7A096, C7A098, C7A1, C7A8, C7B00, C7B01, C7B02, C7B03, C7B04, C7B1, C7B09, C7B8, D0000, D0001, D0002, D0003, D0004, D0005, D0006, D0007, D0008, D001, D002, D010, D011, D012, D013, D0140, D0149, D015, D017, D019, D020, D021, D0220, D0221, D0222, D023, D024, D0500, D0501, D0502, D0510, D0511, D0512, D0580, D0581, D0582, D0590, D0591, D0592, D060, D061, D067, D069, D070, D0730, D072, D071, D0739, D075, D074, D0760, D0761, D0769, D090, D0910, D0919, D0920, D0921, D0922, D093, D098, D099, D37030, D37031, D37032, D37039, D3701, D3702, D3704, D3705, D3709, D371, D372, D373, D374, D375, D376, D483, D484, D378, D379, D380, D381, D382, D383, D384, D385, D386, D390, D392, D3910, D3911, D3912, D398, D399, D4010, D4011, D4012, D400, D408, D409, D414, D419, D4100, D4101, D4102, D4110, D4111, D4112, D4120, D4121, D4122, D413, D418, D443, D444, D445, D4410, D4411, D4412, D446, D447, D440, D442, D449, D430, D431, D432, D434, D420, D421, D429, Q8500, Q8501, Q8502, Q8503, Q8509, D433, D438, D439, D480, D481, D482, D485, D4860, D4861, D4862, D45, D470, D473, D460, D461, D4620, D4621, D464, D46A, D46B, D4622, D46C, D469, D46Z, D47Z1, C888, C9440, C9441, C9442, C946, D471, D479, D47Z9, D487, D489, D490, D491, D492, D493, D494, D495, D496, D497, D4981, D4989, D499, E3122, E3123, D831, D806, D808, D809, M300, M302, M308, M317, M303, M310, M312, M301, M3130, M3131, M315, M316, M311, M314, I776, J910, N185, N186, O030, O0337, O035, O0387, O031, O036, O0334, O0384, O0332, O0382, O0333, O0383, O0331, O0381, O037, O032, O0335, O0336, O0338, O0339, O0385, O0386, O0388, O0389, O0330, O0380, O034, O039, A34, O080, O0882, O081, O086, O084, O085, O083, O082, O087, O0881, O0883, O0889, O089, O320XX0, O320XX1, O320XX2, O320XX3, O320XX4, O320XX5, O320XX9, O321XX0, O321XX1, O321XX2, O321XX3, O321XX4, O321XX5, O321XX9, O641XX0, O641XX1, O641XX2, O641XX3, O641XX4, O641XX5, O641XX9, O322XX0, O322XX1, O322XX2, O322XX3, O322XX4, O322XX5, O322XX9, O323XX0, O323XX1, O323XX2, O323XX3, O323XX4, O323XX5, O323XX9, O642XX0, O642XX1, O642XX2, O642XX3, O642XX4, O642XX5, O642XX9, O643XX0, O643XX1, O643XX2, O643XX3, O643XX4, O643XX5, O643XX9, O324XX0, O324XX1, O324XX2, O324XX3, O324XX4, O324XX5, O324XX9, O329XX0, O329XX1, O329XX2, O329XX3, O329XX4, O329XX5,
11 Asthma Algorithm Summary v1.6 Page 11 of 15 codes ICD-10-CM codes: O329XX9, O666, O326XX0, O326XX1, O326XX2, O326XX3, O326XX4, O326XX5, O326XX9, O328XX0, O328XX1, O328XX2, O328XX3, O328XX4, O328XX5, O328XX9, O644XX0, O644XX1, O644XX2, O644XX3, O644XX4, O644XX5, O644XX9, O645XX0, O645XX1, O645XX2, O645XX3, O645XX4, O645XX5, O645XX9, O648XX0, O648XX1, O648XX2, O648XX3, O648XX4, O648XX5, O648XX9, O649XX0, O649XX1, O649XX2, O649XX3, O649XX4, O649XX5, O649XX9, O650, O331, O651, O332, O652, O333XX0, O333XX1, O333XX2, O333XX3, O333XX4, O333XX5, O333XX9, O653, O334XX0, O334XX1, O334XX2, O334XX3, O334XX4, O334XX5, O334XX9, O654, O335XX0, O335XX1, O335XX2, O335XX3, O335XX4, O335XX5, O335XX9, O662, O336XX0, O336XX1, O336XX2, O336XX3, O336XX4, O336XX5, O336XX9, O337, O338, O339, O409XX0, O409XX1, O409XX2, O409XX3, O409XX4, O409XX5, O409XX9, O401XX0, O401XX1, O401XX2, O401XX3, O401XX4, O401XX5, O401XX9, O402XX0, O402XX1, O402XX2, O402XX3, O402XX4, O402XX5, O402XX9, O403XX0, O403XX1, O403XX2, O403XX3, O403XX4, O403XX5, O403XX9, O4100X0, O4100X1, O4100X2, O4100X3, O4100X4, O4100X5, O4100X9, O4101X0, O4101X1, O4101X2, O4101X3, O4101X4, O4101X5, O4101X9, O4102X0, O4102X1, O4102X2, O4102X3, O4102X4, O4102X5, O4102X9, O4103X0, O4103X1, O4103X2, O4103X3, O4103X4, O4103X5, O4103X9, O4200, O42019, O4290, O42919, O4200, O42011, O42012, O42013, O4202, O42911, O42912, O42913, O4292, O42119, O4210, O42111, O42112, O42113, O4212, O755, O411090, O411091, O411092, O411093, O411094, O411095, O411099, O411290, O411291, O411292, O411293, O411294, O411295, O411299, O411490, O411491, O411492, O411493, O411494, O411495, O411499, O411010, O411011, O411012, O411013, O411014, O411015, O411019, O411020, O411021, O411022, O411023, O411024, O411025, O411029, O411030, O411031, O411032, O411033, O411034, O411035, O411039, O411210, O411211, O411212, O411213, O411214, O411215, O411219, O411220, O411221, O411222, O411223, O411224, O411225, O411229, O411230, O411231, O411232, O411233, O411234, O411235, O411239, O411410, O411411, O411412, O411413, O411414, O411415, O411419, O411420, O411421, O411422, O411423, O411424, O411425, O411429, O411430, O411431, O411432, O411433, O411434, O411435, O411439, O418X90, O418X91, O418X92, O418X93, O418X94, O418X95, O418X99, O418X10, O418X11, O418X12, O418X13, O418X14, O418X15, O418X19, O418X20, O418X21, O418X22, O418X23, O418X24, O418X25, O418X29, O418X30, O418X31, O418X32, O418X33, O418X34, O418X35, O418X39, O4190X0, O4190X1, O4190X2, O4190X3, O4190X4, O4190X5, O4190X9, O4191X0, O4191X1, O4191X2, O4191X3, O4191X4, O4191X5, O4191X9, O4192X0, O4192X1, O4192X2, O4192X3, O4192X4, O4192X5, O4192X9, O4193X0, O4193X1, O4193X2, O4193X3, O4193X4, O4193X5, O4193X9, O641XX0, O641XX1, O641XX2, O641XX3, O641XX4, O641XX5, O641XX9, O642XX0, O642XX1, O642XX2, O642XX3, O642XX4, O642XX5, O642XX9, O643XX0, O643XX1, O643XX2, O643XX3, O643XX4, O643XX5, O643XX9, O644XX0, O644XX1, O644XX2, O644XX3, O644XX4, O644XX5, O644XX9, O645XX0, O645XX1, O645XX2, O645XX3, O645XX4, O645XX5, O645XX9, O648XX0, O648XX1, O648XX2, O648XX3, O648XX4, O648XX5, O648XX9, O649XX0, O649XX1, O649XX2, O649XX3, O649XX4, O649XX5, O649XX9, O650, O651, O652, O653, O654, O655, O658, O659, O640XX0, O640XX1, O640XX2, O640XX3, O640XX4, O640XX5, O640XX9, O660, O661, O6640, O6641, O662, O663, O666, O668, O669, O620, O621, O622, O623, O624, O628, O629, O630, O639, O631, O632, O690XX0, O690XX1, O690XX2, O690XX3, O690XX4, O690XX5, O690XX9, O691XX0, O691XX1, O691XX2, O691XX3, O691XX4, O691XX5, O691XX9, O692XX0, O692XX1, O692XX2, O692XX3, O692XX4, O692XX5, O692XX9, O6981X0, O6981X1, O6981X2, O6981X3, O6981X4, O6981X5, O6981X9, O6982X0, O6982X1, O6982X2, O6982X3, O6982X4, O6982X5, O6982X9, O6989X0, O6989X1, O6989X2, O6989X3, O6989X4, O6989X5, O6989X9, O693XX0, O693XX1, O693XX2, O693XX3, O693XX4, O693XX5, O693XX9, O694XX0, O694XX1, O694XX2, O694XX3, O694XX4, O694XX5, O694XX9, O695XX0, O695XX1, O695XX2, O695XX3, O695XX4, O695XX5, O695XX9, O43129, O43121, O43122, O43123, O699XX0, O699XX1, O699XX2, O699XX3, O699XX4, O699XX5, O699XX9, O665, O30029, O30021, O30022, O30023, P000, P001, P002, P003, P004, P005, P007, P006, P041, Q861, P042, P045, P046, P048, P049, Q862, Q868, P0081, P9681, P009, P010, P011, P012, P013, P014, P015, P016, P017, P018, P019, P020, P021, P0220, P0229, P023, P024, P025, P0260, P0269, P027, P028, P029, P030, P031, P032, P033, P034,
12 Asthma Algorithm Summary v1.6 Page 12 of 15 codes ICD-10-CM codes: P040, P035, P036, P03810, P03811, P03819, P0382, P0389, P039, P080, P081, P0821, P0822, P220, P230, P231, P232, P233, P234, P235, P236, P238, P239, P249, P2400, P2401, P2410, P2411, P2420, P2421, P2480, P2481, P250, P251, P252, P253, P258, P260, P261, P268, P269, P280, P2810, P2811, P2819, P221, P270, P271, P278, P279, P283, P284, P282, P285, P2430, P2431, P2881, P228, P229, P2889, P289, P350, P351, P352, P353, P358, P359, P370, P371, P372, P373, P374, P378, P379, A33, P381, P389, P390, P391, P375, P393, P392, P394, P398, P399, P500, P501, P502, P503, P504, P505, P508, P509, P102, P523, P520, P521, P5221, P5222, P103, P525, P510, P518, P519, P541, P542, P543, P544, P545, P540, P546, P548, P549, P550, P551, P558, P559, P560, P5690, P5699, P570, P580, P581, P582, P583, P5841, P5842, P585, P588, P589, P590, P598, P593, P591, P5920, P5929, P599, P578, P579, P700, P701, P702, P940, P721, P710, P711, P712, P713, P714, P718, P719, P741, P742, P743, P744, P703, P704, P740, P84, P708, P720, P722, P728, P745, P746, P748, P709, P729, P749, P53, P610, P60, P616, P611, P613, P614, P612, P615, P618, P619, P760, P762, P782, P761, P779, P771, P772, P773, P780, P768, P769, P781, P783, P7881, P7882, P7883, P7889, P789, P832, P830, P800, P808, P809, P810, P818, P819, P8330, P8339, P835, P834, P831, P836, P838, P839, P90, P918, P919, P910, P911, P913, P914, P915, P921, P922, P923, P924, P925, P928, P929, P9201, P9209, P926, P930, P938, P912, P2912, P2911, P9682, P9683, P2981, P290, P292, P294, P2989, P299, P941, P942, P948, P949, P960, P963, P965, P9689, P95, P969, R6812, R6811, R180, R1083, O289, R87614, R87620, R87621, R87622, R87623, R87624, R75, R85619, R85610, R85611, R85612, R85613, R85614, T510X1S, T510X2S, T510X3S, T510X4S, T511X1S, T511X2S, T511X3S, T511X4S, T512X1S, T512X2S, T512X3S, T512X4S, T513X1S, T513X2S, T513X3S, T513X4S, T518X1S, T518X2S, T518X3S, T518X4S, T5191XS, T5192XS, T5193XS, T5194XS, T520X1S, T520X2S, T520X3S, T520X4S, T521X1S, T521X2S, T521X3S, T521X4S, T522X1S, T522X2S, T522X3S, T522X4S, T523X1S, T523X2S, T523X3S, T523X4S, T524X1S, T524X2S, T524X3S, T524X4S, T528X1S, T528X2S, T528X3S, T528X4S, T5291XS, T5292XS, T5293XS, T5294XS, T530X1S, T530X2S, T530X3S, T530X4S, T531X1S, T531X2S, T531X3S, T531X4S, T532X1S, T532X2S, T532X3S, T532X4S, T533X1S, T533X2S, T533X3S, T533X4S, T534X1S, T534X2S, T534X3S, T534X4S, T535X1S, T535X2S, T535X3S, T535X4S, T536X1S, T536X2S, T536X3S, T536X4S, T537X1S, T537X2S, T537X3S, T537X4S, T5391XS, T5392XS, T5393XS, T5394XS, T540X1S, T540X2S, T540X3S, T540X4S, T541X1S, T541X2S, T541X3S, T541X4S, T542X1S, T542X2S, T542X3S, T542X4S, T543X1S, T543X2S, T543X3S, T543X4S, T5491XS, T5492XS, T5493XS, T5494XS, T550X1S, T550X2S, T550X3S, T550X4S, T551X1S, T551X2S, T551X3S, T551X4S, T560X1S, T560X2S, T560X3S, T560X4S, T561X1S, T561X2S, T561X3S, T561X4S, T562X1S, T562X2S, T562X3S, T562X4S, T563X1S, T563X2S, T563X3S, T563X4S, T564X1S, T564X2S, T564X3S, T564X4S, T565X1S, T565X2S, T565X3S, T565X4S, T566X1S, T566X2S, T566X3S, T566X4S, T567X1S, T567X2S, T567X3S, T567X4S, T56811S, T56812S, T56813S, T56814S, T56891S, T56892S, T56893S, T56894S, T5691XS, T5692XS, T5693XS, T5694XS, T570X1S, T570X2S, T570X3S, T570X4S, T571X1S, T571X2S, T571X3S, T571X4S, T572X1S, T572X2S, T572X3S, T572X4S, T573X1S, T573X2S, T573X3S, T573X4S, T578X1S, T578X2S, T578X3S, T578X4S, T5791XS, T5792XS, T5793XS, T5794XS, T5801XS, T5802XS, T5803XS, T5804XS, T5811XS, T5812XS, T5813XS, T5814XS, T582X1S, T582X2S, T582X3S, T582X4S, T588X1S, T588X2S, T588X3S, T588X4S, T5891XS, T5892XS, T5893XS, T5894XS, T590X1S, T590X2S, T590X3S, T590X4S, T591X1S, T591X2S, T591X3S, T591X4S, T592X1S, T592X2S, T592X3S, T592X4S, T593X1S, T593X2S, T593X3S, T593X4S, T594X1S, T594X2S, T594X3S, T594X4S, T595X1S, T595X2S, T595X3S, T595X4S, T596X1S, T596X2S, T596X3S, T596X4S, T597X1S, T597X2S, T597X3S, T597X4S, T59811S, T59812S, T59813S, T59814S, T59891S, T59892S, T59893S, T59894S, T5991XS, T5992XS, T5993XS, T5994XS, T600X1S, T600X2S, T600X3S, T600X4S, T601X1S, T601X2S, T601X3S, T601X4S, T602X1S, T602X2S, T602X3S, T602X4S, T603X1S, T603X2S, T603X3S, T603X4S, T604X1S, T604X2S, T604X3S, T604X4S, T608X1S, T608X2S, T608X3S, T608X4S, T6091XS, T6092XS, T6093XS, T6094XS, T6101XS, T6102XS, T6103XS, T6104XS, T6111XS, T6112XS, T6113XS, T6114XS, T61771S, T61772S, T61773S, T61774S, T61781S, T61782S, T61783S, T61784S, T618X1S, T618X2S, T618X3S, T618X4S, T6191XS, T6192XS, T6193XS, T6194XS, T620X1S, T620X2S, T620X3S, T620X4S, T621X1S, T621X2S, T621X3S, T621X4S, T622X1S, T622X2S, T622X3S, T622X4S, T628X1S, T628X2S, T628X3S, T628X4S, T6291XS, T6292XS, T6293XS, T6294XS, T63001S, T63002S, T63003S, T63004S,
13 Asthma Algorithm Summary v1.6 Page 13 of 15 codes ICD-10-CM codes: T63011S, T63012S, T63013S, T63014S, T63021S, T63022S, T63023S, T63024S, T63031S, T63032S, T63033S, T63034S, T63041S, T63042S, T63043S, T63044S, T63061S, T63062S, T63063S, T63064S, T63071S, T63072S, T63073S, T63074S, T63081S, T63082S, T63083S, T63084S, T63091S, T63092S, T63093S, T63094S, T63111S, T63112S, T63113S, T63114S, T63121S, T63122S, T63123S, T63124S, T63191S, T63192S, T63193S, T63194S, T632X1S, T632X2S, T632X3S, T632X4S, T63301S, T63302S, T63303S, T63304S, T63311S, T63312S, T63313S, T63314S, T63321S, T63322S, T63323S, T63324S, T63331S, T63332S, T63333S, T63334S, T63391S, T63392S, T63393S, T63394S, T63411S, T63412S, T63413S, T63414S, T63421S, T63422S, T63423S, T63424S, T63431S, T63432S, T63433S, T63434S, T63441S, T63442S, T63443S, T63444S, T63451S, T63452S, T63453S, T63454S, T63461S, T63462S, T63463S, T63464S, T63481S, T63482S, T63483S, T63484S, T63511S, T63512S, T63513S, T63514S, T63591S, T63592S, T63593S, T63594S, T63611S, T63612S, T63613S, T63614S, T63621S, T63622S, T63623S, T63624S, T63631S, T63632S, T63633S, T63634S, T63691S, T63692S, T63693S, T63694S, T63711S, T63712S, T63713S, T63714S, T63791S, T63792S, T63793S, T63794S, T63811S, T63812S, T63813S, T63814S, T63821S, T63822S, T63823S, T63824S, T63831S, T63832S, T63833S, T63834S, T63891S, T63892S, T63893S, T63894S, T6391XS, T6392XS, T6393XS, T6394XS, T6401XS, T6402XS, T6403XS, T6404XS, T6481XS, T6482XS, T6483XS, T6484XS, T650X1S, T650X2S, T650X3S, T650X4S, T651X1S, T651X2S, T651X3S, T651X4S, T65211S, T65212S, T65213S, T65214S, T65221S, T65222S, T65223S, T65224S, T65291S, T65292S, T65293S, T65294S, T653X1S, T653X2S, T653X3S, T653X4S, T654X1S, T654X2S, T654X3S, T654X4S, T655X1S, T655X2S, T655X3S, T655X4S, T656X1S, T656X2S, T656X3S, T656X4S, T65811S, T65812S, T65813S, T65814S, T65821S, T65822S, T65823S, T65824S, T65831S, T65832S, T65833S, T65834S, T65891S, T65892S, T65893S, T65894S, T6591XS, T6592XS, T6593XS, T6594XS, T511X1A, T511X2A, T511X3A, T511X4A, T512X1A, T512X2A, T512X3A, T512X4A, T513X1A, T513X2A, T513X3A, T513X4A, T518X1A, T518X2A, T518X3A, T518X4A, T5191XA, T5192XA, T5193XA, T5194XA, T520X1A, T520X2A, T520X3A, T520X4A, T521X1A, T521X2A, T521X3A, T521X4A, T522X1A, T522X2A, T522X3A, T522X4A, T653X1A, T653X2A, T653X3A, T653X4A, T530X1A, T530X2A, T530X3A, T530X4A, T654X1A, T654X2A, T654X3A, T654X4A, T531X1A, T531X2A, T531X3A, T531X4A, T532X1A, T532X2A, T532X3A, T532X4A, T533X1A, T533X2A, T533X3A, T533X4A, T534X1A, T534X2A, T534X3A, T534X4A, T536X1A, T536X2A, T536X3A, T536X4A, T537X1A, T537X2A, T537X3A, T537X4A, T5391XA, T5392XA, T5394XA, T523X1A, T523X2A, T523X3A, T523X4A, T524X1A, T524X2A, T524X3A, T524X4A, T528X1A, T528X2A, T528X3A, T528X4A, T5291XA, T5292XA, T5293XA, T5294XA, T540X1A, T540X2A, T540X3A, T540X4A, T542X1A, T542X2A, T542X3A, T542X4A, T543X1A, T543X2A, T543X3A, T543X4A, T541X1A, T541X2A, T541X3A, T541X4A, T5491XA, T5492XA, T5493XA, T5494XA, T571X1A, T571X2A, T571X3A, T571X4A, M1A10X0, M1A10X1, M1A1110, M1A1111, M1A1120, M1A1121, M1A1190, M1A1191, M1A1210, M1A1211, M1A1220, M1A1221, M1A1290, M1A1291, M1A1310, M1A1311, M1A1320, M1A1321, M1A1390, M1A1391, M1A1410, M1A1411, M1A1420, M1A1421, M1A1490, M1A1491, M1A1510, M1A1511, M1A1520, M1A1521, M1A1590, M1A1591, M1A1610, M1A1611, M1A1620, M1A1621, M1A1690, M1A1691, M1A1710, M1A1711, M1A1720, M1A1721, M1A1790, M1A1791, M1A18X0, M1A18X1, M1A19X0, M1A19X1, T560X1A, T560X2A, T560X3A, T560X4A, T561X1A, T561X2A, T561X3A, T561X4A, T570X1A, T570X2A, T570X3A, T570X4A, T572X1A, T572X2A, T572X3A, T572X4A, T567X1A, T567X2A, T567X3A, T567X4A, T563X1A, T563X2A, T563X3A, T563X4A, T562X1A, T562X2A, T562X3A, T562X4A, T564X1A, T564X2A, T564X3A, T564X4A, T565X1A, T565X2A, T565X3A, T565X4A, T566X1A, T566X2A, T566X3A, T566X4A, T56811A, T56812A, T56813A, T56814A, T56891A, T56892A, T56893A, T56894A, T5691XA, T5692XA, T5693XA, T5694XA, T5801XA, T5802XA, T5803XA, T5804XA, T5811XA, T5812XA, T5813XA, T5814XA, T582X1A, T582X2A, T582X3A, T582X4A, T588X1A, T588X2A, T588X3A, T588X4A, T5891XA, T5892XA, T5893XA, T5894XA, T592X1A, T592X2A, T592X3A, T592X4A, T590X1A, T590X2A, T590X3A, T590X4A, T591X1A, T591X2A, T591X3A, T591X4A, T535X1A, T535X2A, T535X3A, T535X4A, T593X1A, T593X2A, T593X3A, T593X4A, T594X1A, T594X2A, T594X3A, T594X4A, T573X1A, T573X2A, T573X3A, T573X4A, T595X1A, T595X2A, T595X3A, T595X4A, T596X1A, T596X2A, T596X3A, T596X4A, T597X1A, T597X2A, T597X3A, T597X4A, T59811A, T59812A, T59813A, T59814A, T59891A, T59892A, T59893A, T59894A, T5991XA, T5992XA, T5993XA, T5994XA, T6101XA, T6102XA, T6103XA,
14 Asthma Algorithm Summary v1.6 Page 14 of 15 codes ICD-10-CM codes: T6104XA, T6111XA, T6112XA, T6113XA, T6114XA, T61771A, T61772A, T61773A, T61774A, T61781A, T61782A, T61783A, T61784A, T618X1A, T618X2A, T618X3A, T618X4A, T6191XA, T6192XA, T6193XA, T6194XA, T620X1A, T620X2A, T620X3A, T620X4A, T621X1A, T621X2A, T621X3A, T621X4A, T622X1A, T622X2A, T622X3A, T622X4A, T628X1A, T628X2A, T628X3A, T628X4A, T6291XA, T6292XA, T6293XA, T6294XA, T650X1A, T650X2A, T650X3A, T650X4A, T651X1A, T651X2A, T651X3A, T651X4A, T5393XA, T600X1A, T600X2A, T600X3A, T600X4A, T601X1A, T601X2A, T601X3A, T601X4A, T602X1A, T602X2A, T602X3A, T602X4A, T604X1A, T604X2A, T604X3A, T604X4A, T608X1A, T608X2A, T608X3A, T608X4A, T6091XA, T6092XA, T6093XA, T6094XA, T63001A, T63002A, T63003A, T63004A, T63011A, T63012A, T63013A, T63014A, T63021A, T63022A, T63023A, T63024A, T63031A, T63032A, T63033A, T63034A, T63041A, T63042A, T63043A, T63044A, T63061A, T63062A, T63063A, T63064A, T63071A, T63072A, T63073A, T63074A, T63081A, T63082A, T63083A, T63084A, T63091A, T63092A, T63093A, T63094A, T63111A, T63112A, T63113A, T63114A, T63121A, T63122A, T63123A, T63124A, T63191A, T63192A, T63193A, T63194A, T632X1A, T632X2A, T632X3A, T632X4A, T63301A, T63302A, T63303A, T63304A, T63311A, T63312A, T63313A, T63314A, T63321A, T63322A, T63323A, T63324A, T63331A, T63332A, T63333A, T63334A, T63391A, T63392A, T63393A, T63394A, T63411A, T63412A, T63413A, T63414A, T63421A, T63422A, T63423A, T63424A, T63431A, T63432A, T63433A, T63434A, T63441A, T63442A, T63443A, T63444A, T63451A, T63452A, T63453A, T63454A, T63461A, T63462A, T63463A, T63464A, T63481A, T63482A, T63483A, T63484A, T63511A, T63512A, T63513A, T63514A, T63591A, T63592A, T63593A, T63594A, T63611A, T63612A, T63613A, T63614A, T63621A, T63622A, T63623A, T63624A, T63631A, T63632A, T63633A, T63634A, T63691A, T63692A, T63693A, T63694A, T63711A, T63712A, T63713A, T63714A, T63791A, T63792A, T63793A, T63794A, T63811A, T63812A, T63813A, T63814A, T63821A, T63822A, T63823A, T63824A, T63831A, T63832A, T63833A, T63834A, T63891A, T63892A, T63893A, T63894A, T6391XA, T6392XA, T6393XA, T6394XA, T550X1A, T550X2A, T550X3A, T550X4A, T551X1A, T551X2A, T551X3A, T551X4A, T6401XA, T6402XA, T6403XA, T6404XA, T6481XA, T6482XA, T6483XA, T6484XA, T65811A, T65812A, T65813A, T65814A, T65211A, T65212A, T65213A, T65214A, T65221A, T65222A, T65223A, T65224A, T65291A, T65292A, T65293A, T65294A, T578X1A, T578X2A, T578X3A, T578X4A, T603X1A, T603X2A, T603X3A, T603X4A, T655X1A, T655X2A, T655X3A, T655X4A, T656X1A, T656X2A, T656X3A, T656X4A, T65821A, T65822A, T65823A, T65824A, T65831A, T65832A, T65833A, T65834A, T65891A, T65892A, T65893A, T65894A, T5791XA, T5792XA, T5793XA, T5794XA, T6591XA, T6592XA, T6593XA, T6594XA, T8690, T8691, T8692, T8693, T8699, T8610, T8611, T8612, T8613, T8619, T8640, T8641, T8642, T8643, T8649, T8620, T8621, T8622, T8623, T86290, T86298, T8630, T8631, T8632, T8633, T8639, T8630, T8631, T8632, T8633, T8639, T86810, T86811, T86812, T86818, T86819, T8600, T8601, T8602, T8603, T8609, T86890, T86891, T86892, T86898, T86899, T86850, T86851, T86852, T86858, T86859, T865, T86830, T86831, T86832, T86838, T86839, T39012A, T39092A, T392X2A, T39312A, T39392A, T394X2A, T398X2A, T3992XA, T400X2A, T401X2A, T403X2A, T411X2A, T41202A, T41292A, T413X2A, T4142XA, T407X2A, T408X2A, T40902A, T40992A, T4272XA, T43012A, T43022A, T431X2A, T43202A, T43212A, T43222A, T43292A, T433X2A, T434X2A, T43502A, T43592A, T43602A, T43612A, T43622A, T43632A, T43692A, T438X2A, T4392XA, T360X2A, T361X2A, T362X2A, T363X2A, T364X2A, T365X2A, T366X2A, T367X2A, T368X2A, T3692XA, T370X2A, T371X2A, T372X2A, T373X2A, T374X2A, T375X2A, T378X2A, T3792XA, T380X2A, T381X2A, T382X2A, T383X2A, T384X2A, T385X2A, T386X2A, T387X2A, T38802A, T38812A, T38892A, T38902A, T38992A, T405X2A, T420X2A, T421X2A, T422X2A, T425X2A, T426X2A, T428X2A, T440X2A, T441X2A, T442X2A, T443X2A, T444X2A, T445X2A, T446X2A, T447X2A, T448X2A, T44902A, T44992A, T450X2A, T451X2A, T452X2A, T453X2A, T454X2A, T45512A, T45522A, T45602A, T45612A, T45622A, T45692A, T457X2A, T458X2A, T4592XA, T460X2A, T461X2A, T462X2A, T463X2A, T464X2A, T465X2A, T466X2A, T467X2A, T468X2A, T46902A, T46992A, T470X2A, T471X2A, T472X2A, T473X2A, T474X2A, T475X2A, T476X2A, T477X2A, T478X2A, T4792XA, T480X2A, T481X2A, T48202A, T48292A, T483X2A, T484X2A, T485X2A, T486X2A, T48902A, T48992A, T490X2A, T491X2A, T492X2A, T493X2A, T494X2A, T495X2A, T496X2A, T497X2A, T498X2A, T4992XA, T500X2A, T501X2A, T502X2A, T503X2A, T504X2A, T505X2A, T506X2A, T507X2A, T508X2A, T50902A, T50992A, T50A12A, T50A22A, T50A92A, T50B12A, T50B92A, T50Z12A, T50Z92A, T600X2A, T540X2A,
Arkansas Health Care Payment Improvement Initiative COPD Algorithm Summary
Arkansas Health Care Payment Improvement Initiative COPD Algorithm Summary Chronic Obstructive Pulmonary Disease (COPD) Algorithm Summary v1.6 Page 2 of 6 Triggers PAP Assignment Exclusions Episode Time
More informationPRINCIPAL ACCOUNTABLE PROVIDER MANUAL
Health Care Payment Improvement Building a healthier future for all Arkansans Arkansas Payment Improvement Initiative Episodes of Care PRINCIPAL ACCOUNTABLE PROVIDER MANUAL COPD Episode Reimbursement Program
More informationArkansas Health Care Payment Improvement Initiative CABG Algorithm Summary
Arkansas Health Care Payment Improvement Initiative CABG Algorithm Summary CABG Algorithm Summary v1.6 Page 2 of 25 Triggers PAP assignment Exclusions Episode time window An episode is triggered when a
More informationArkansas Health Care Payment Improvement Initiative Percutaneous Coronary Intervention Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Percutaneous Coronary Intervention Algorithm Summary Percutaneous Coronary Intervention (PCI) Algorithm Summary v1.0 Page 2 of 8 Triggers PAP assignment
More informationArkansas Health Care Payment Improvement Initiative Tonsillectomy/Adenoidectomy Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Tonsillectomy/Adenoidectomy Algorithm Summary Tonsillectomy/Adenoidectomy Algorithm Summary v1.6 Page 2 of 12 Triggers PAP assignment s An episode is
More informationArkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary Congestive Heart Failure Algorithm Summary v1.2 (1/5) Triggers PAP assignment Exclusions Episode time window
More informationPRINCIPAL ACCOUNTABLE PROVIDER MANUAL
Health Care Payment Improvement Building a healthier future for all Arkansans Arkansas Payment Improvement Initiative Episodes of Care PRINCIPAL ACCOUNTABLE PROVIDER MANUAL Tonsillectomy/Adenoidectomy
More informationArkansas Health Care Payment Improvement Initiative Total Knee and Total Hip Replacement Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Total Knee and Total Hip Replacement Algorithm Summary Triggers Total Knee and Total Hip Replacement Algorithm Summary v1.6 Page 2 of 5 PAP assignment
More informationPRINCIPAL ACCOUNTABLE PROVIDER MANUAL
Health Care Payment Improvement Building a healthier future for all Arkansans Arkansas Payment Improvement Initiative Episodes of Care PRINCIPAL ACCOUNTABLE PROVIDER MANUAL Hip and Knee Replacement Episode
More informationHu J, Gonsahn MD, Nerenz DR. Socioeconomic status and readmissions: evidence from an urban teaching hospital. Health Aff (Millwood). 2014;33(5).
Appendix Definitions of Index Admission and Readmission Definitions of index admission and readmission follow CMS hospital-wide all-cause unplanned readmission (HWR) measure as far as data are available.
More informationTENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 3 Episodes
TENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 3 Episodes Respiratory Infection (RI); Pneumonia (PNA); Inpatient Urinary Tract Infection (UTI-I; Outpatient Urinary
More informationTENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 2 Episodes
TENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 2 Episodes Acute COPD exacerbation (COPD); Screening and surveillance colonoscopy (COL); and Outpatient and non-acute
More informationTENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 5 Episodes
TENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 5 Episodes Mastectomy, Breast Cancer Medical Oncology, Breast Biopsy, Tonsillectomy, Otitis media, Anxiety, Non-emergent
More informationTENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 8 Episodes
TENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 8 Episodes Acute Seizure, Syncope, Acute Gastroenteritis, Pediatric Pneumonia, Bronchiolitis, Colposcopy, Hysterectomy,
More informationTENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 4 Episodes
TENNCARE Bundled Payment Initiative: Description of Bundle Risk Adjustment for Wave 4 Episodes Attention deficit hyperactivity disorder (ADHD); Opposition defiance disorder (ODD); Coronary artery bypass
More informationNov FromAtoZCodesMatter
Nov 2017 FromAtoZCodesMatter From A to Z-Codes Matter Susan Wallace, MEd, RHIA, CCS, CDIP, CCDS, FAHIMA The implementation of ICD-10 brought tens of thousands of new codes. Ranging from A to Z, they portray
More informationFrom A to Z-Codes Matter
From A to Z-Codes Matter Susan Wallace, MEd, RHIA, CCS, CDIP, CCDS, FAHIMA While ALL ICD-10-CM codes are important, the Z-codes in ICD-10-CM are frequently considered step-children, supplemental codes
More informationSupplementary Online Content
Supplementary Online Content Henson KE, Brock R, Charnock J, Wickramasinghe B, Will O, Pitman A. Risk of suicide after cancer diagnosis in England. JAMA Psychiatry. Published online November 21, 2018.
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARD FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Outcome Measures (Claims Based)
Last Updated: Version 4.3 NQF-ENDORSED VOLUNTARY CONSENSUS STANDARD FOR HOSPITAL CARE Measure Information Form Collected For: CMS Outcome Measures (Claims Based) Measure Set: CMS Readmission Measures Set
More informationSelected tables standardised to Segi population
Selected tables standardised to Segi population LIST OF TABLES Table 4.2S: Selected causes of death, all-ages, 2000 2004 (Segi Standard) Table 5.3S: Public hospitalisations by major cause of admission
More information79 HCCs CMS-HCC Risk Adjustment Model. ICD-10-CM to CMS-HCC Crosswalk. Over 9,500 ICD-10-CM codes map to one or more.
2017 CMS-HCC Risk Adjustment Model Over 9,500 ICD-10-CM codes map to one or more 79 HCCs ICD-10-CM to CMS-HCC Crosswalk CMS-HCC Model On April 4, 2016, the Centers for Medicare & Medicaid Services (CMS)
More informationEpidemiology in Texas 2006 Annual Report. Cancer
Epidemiology in Texas 2006 Annual Report Cancer Epidemiology in Texas 2006 Annual Report Page 94 Cancer Incidence and Mortality in Texas, 2000-2004 The Texas Department of State Health Services Texas Cancer
More informationUnitedHealth Premium Physician Designation Program Episode Treatment Groups (ETG ) Description and Specialty
UnitedHealth Premium Physician Designation Program Episode Treatment Groups (ETG ) Description and Specialty 666700 Acne Family Medicine, Internal Medicine, Pediatrics 438300 Acute Bronchitis Allergy,
More informationTable E1. Standardized Mortality Ratios for Total and Specific Causes of Death Parameter Radiologists Psychiatrists No. of Deaths
RSNA, 2016 10.1148/radiol.2016152472 Table E1. Standardized Mortality Ratios for Total and Specific Causes of Death Parameter Radiologists Psychiatrists No. of Deaths Observed/Expected No. of Deaths Observed/Expected
More informationAttending Physician s Statement
( Form A A This form is used for claiming the social insurance benefit. This form should be completed and signed by the attending physician outpatient and One form for each month, one form for hospitalization
More informationClinical Quality Measures Summary of Upcoming Enhancements
Upcoming coding enhancements will impact the logic behind the clinical quality indicators applicable to your practice specialty. Please refer to this grid for a summary of the coding enhancements and some
More informationSuicides increased in 2014
Causes of death 2014 23 May, 2016 Suicides increased in 2014 Diseases of the circulatory system accounted for 30.7% of the deaths recorded in 2014, 2.4% more than in the previous year. The average age
More informationPHO: Metadata for Mortality from Avoidable Causes
Snapshots @ PHO: Metadata for Mortality from Avoidable Causes This indicator captures individuals under 75 years of age who have died with a condition considered as avoidable recorded as the primary cause
More informationAppendix A: List of Clinical Classification Software Diagnostic Categories Excluded from Calculation of HIV-Related Inpatient Days
supplemental digitai content Appendix A: List of Clinical Classification Software Diagnostic Categories Excluded from Calculation of HIV-Related Inpatient Days CCS Category Description 80 Multiple sclerosis
More informationMerit-based Incentive Payment System (MIPS): Cost Measure Field Test Reports Fact Sheet
Merit-based Incentive Payment System (MIPS): Cost Measure Field Test Reports Fact Sheet The Quality Payment Program The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality
More informationInpatient Psychiatric Facilities
Payment Integrity Compass Inpatient Psychiatric Facilities Understanding IPF Calculations Updated 12/05/12 2 Questions from the Group Please use GoToMeeting to Ask a Question Use the Raise Hand function
More informationQuality measures a for measurement year 2016
Quality measures a for measurement year 2016 Measure Description Eligible members Childhood immunizations b Adolescent immunizations b Children who turned 2 during the measurement and who were identified
More informationAPPENDIX ONE: ICD CODES
APPENDIX ONE: ICD CODES ICD-10-AM ICD-9-CM Malignant neoplasms C00 C97 140 208, 238.6, 273.3 Lip, oral cavity and pharynx C00 C14 140 149 Digestive organs C15 C26 150 157, 159 Oesophagus 4 C15 150 excluding
More informationObjectives. Medicare Spending per Beneficiary: Analyzing MSPB Data to Identify Primary Drivers
Medicare Spending per Beneficiary: Analyzing MSPB Data to Identify Primary Drivers August 22, 2017 Objectives Understand the basics of the hospital specific MSPB data files and reports Review the factors
More informationEarly Cancer Care FAQ
If you need more information, you can call 6722 2293 (Mon-Fri, 9am-5pm), email our Financial Protection Specialists at financial2@ocbc.com or visit any of our OCBC branches. Q1. What is this Early Cancer
More information0301 Anemia Others. Endocrine nutritional and metabolic disorders Others Vascular dementia and unspecified dementia
Certain infectious and parasitic diseases 0101 Intestinal infectious diseases 0102 Tuberculosis 0103 Infections with a predominantly sexual mode of transmission 0104 Viral infections characterized by skin
More informationAppendix 1 (as supplied by the authors): Supplementary data
Appendix 1 (as supplied by the authors): Supplementary data I. Cancer prevalence in Canada We obtained 10 year person based cancer prevalence rates for all of Canada for some years of our study period
More informationModular Program Report
Disclaimer The following report(s) provides findings from an FDA initiated query using Sentinel. While Sentinel queries may be undertaken to assess potential medical product safety risks, they may also
More informationOutcomes Report: Accountability Measures and Quality Improvements
Outcomes Report: Accountability Measures and Quality Improvements The FH Memorial Medical Center s Cancer Committee ensures that patients with cancer are treated according to the nationally accepted measures.
More informationONLINE DATA SUPPLEMENT - ASTHMA INTERVENTION PROGRAM PREVENTS READMISSIONS IN HIGH HEALTHCARE UTILIZERS
R2 (REVISED MANUSCRIPT BLUE 200208-877OC) ONLINE DATA SUPPLEMENT - ASTHMA INTERVENTION PROGRAM PREVENTS READMISSIONS IN HIGH HEALTHCARE UTILIZERS Mario Castro, M.D., M.P.H. Nina A. Zimmermann R.N. Sue
More informationTN Bundled Payment Initiative: Overview of Episode Risk Adjustment
TN Bundled Payment Initiative: Overview of Episode Risk Adjustment United Healthcare, April 2014 The State of Tennessee has implemented an episode-based approach to reimburse providers for the care delivered
More informationNeoplasms/Lymphoma/Leukemia
Neoplasms/Lymphoma/Leukemia Session Guidelines This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars monthly to address topics related to risk adjustment documentation and
More informationS2 File. Clinical Classifications Software (CCS). The CCS is a
S2 File. Clinical Classifications Software (CCS). The CCS is a diagnosis categorization scheme based on the ICD-9-CM that aggregates all diagnosis codes into 262 mutually exclusive, clinically homogeneous
More informationSpecialty Mapping Guides ICD-9 to ICD-10
Specialty Mapping Guides ICD-9 to ICD-10 The conversions contained within this crosswalk were the most current version at the time of development. All efforts should be made by the attendee to stay current
More informationCancer in Ontario. 1 in 2. Ontarians will develop cancer in their lifetime. 1 in 4. Ontarians will die from cancer
Cancer in Ontario 1 in 2 Ontarians will develop cancer in their lifetime 1 in 4 Ontarians will die from cancer 14 ONTARIO CANCER STATISTICS 2016 1 Cancer in Ontario An overview Cancer is a group of more
More information*
Introduction Cancer is complex, can have many possible causes, and is increasingly common. For the U.S. population, 1 in 2 males and 1 in 3 females is at risk of developing cancer in their lifetime. The
More informationEpisodes of Care Risk Adjustment
Episodes of Care Risk Adjustment Episode Types Wave 1 Asthma Acute Exacerbation Perinatal Total Joint Replacement Wave 2 Acute Percutaneous Coronary Intervention COPD Acute Exacerbation Non-acute Percutaneous
More informationManaging Older Patients With Lymphoma and Multiple Myeloma
2006 ONS Congress Webcast Evaluation Form Managing Older Patients With Lymphoma and Multiple Myeloma Session length: 1 hour, 45 minutes Contact hours: 1.5 Pharmacology hours offered: 15 minutes How to
More informationAPPENDIX A. Comparability Ratios for the Major Causes of Death in North Carolina Vital Statistics, Volume 2
APPENDIX A Comparability Ratios for the Major Causes of Death in North Carolina Vital Statistics, Volume 2 The comparability ratio is an adjustment factor that is applied to the number of deaths coded
More informationRecommendations for Hospital Quality Measures in 2011:
Pediatric Measures: Recommendations for Hospital Quality Measures in 2011: Based on the input of a group of healthcare stakeholders, the following new hospital measures are recommended: 1) Home Management
More informationCase mix and charges for inpatient and outpatient chemotherapy
Case mix and charges for inpatient and outpatient chemotherapy Case mix and charges for chemotherapy treatment were examined by an analysis of the inpatient discharges for DRG 410 (chemotherapy) from eight
More informationComprehensive cancer cover
Retirement Investments Insurance Health Comprehensive cancer cover Life Insurance+ with critical illness and Critical Illness+ Cancer is one of the biggest fears for the British public This is why our
More informationDIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE:
DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: THE BASICS Preferred Clinical Services for Leading Age Florida August 26-27, 2015 WHAT IS ICD-10-CM? International Classification of Diseases, 10 th Revision,
More informationReducing COPD Exacerbation Readmissions in a Community-Based Teaching Hospital
Reducing COPD Exacerbation Readmissions in a Community-Based Teaching Hospital Dawn Waddell, PharmD, BCPS Clinical Pharmacy Manager Lisa Kingdon, PharmD, BCPS Clinical Pharmacy Specialist Dawn Waddell
More informationTECHNICAL NOTES APPENDIX SUMMER
TECHNICAL NOTES APPENDIX SUMMER Hospital Performance Report Summer Update INCLUDES PENNSYLVANIA INPATIENT HOSPITAL DISCHARGES FROM JULY 1, 2006 THROUGH JUNE 30, 2007 The Pennsylvania Health Care Cost Containment
More informationPhase-specific Costs of Cancer Care in Ontario
Phase-specific Costs of Cancer Care in Ontario Canadian Association of Health Services and Policy Research Conference Session: D5 Cancer Care Wednesday May 29 2013 Claire de Oliveira, M.A. PhD Background
More informationRepublican Research and Practical Center for Radiation Medicine and Human Ecology. Ilya Veyalkin Head of Laboratory of Epidemiology Gomel, Belarus
Republican Research and Practical Center for Radiation Medicine and Human Ecology Ilya Veyalkin Head of Laboratory of Epidemiology Gomel, Belarus The contaminated area in the Republic of Belarus consisted
More informationHeart Failure Transitions of Care SJMH - Ann Arbor
Heart Failure Transitions of Care SJMH - Ann Arbor March 4, 2013 Cecelia Montoye, RN, MSN Reducing 30 Day Heart Failure Readmissions: SJMH Ann Arbor See you in 7 Measures Process Measure #4: Identify and
More informationFinland and Sweden and UK GP-HOSP datasets
Web appendix: Supplementary material Table 1 Specific diagnosis codes used to identify bladder cancer cases in each dataset Finland and Sweden and UK GP-HOSP datasets Netherlands hospital and cancer registry
More informationIdentifying and counting people living with treatable but not curable cancer
Identifying and counting people living with treatable but not curable cancer Rachel White Joanna Pethick, Archie Macnair, Gregory Fallica, Jennifer Than and Jane Maher September 2018 Who are the people
More informationFOCUS on Primary Healthcare. October 2018
FOCUS on Primary Healthcare October 2018 Table of Contents Completion of selected screening tests... 1 Lipids (cardiovascular risk) screening... 6 Diabetes screening... 8 Colorectal cancer screening...
More informationSTEPHEN P. NONN OFFICE OF THE CORONER MADISON COUNTY, ILLINOIS 157 MAIN STREET SUITE 354 EDWARDSVILLE, IL
MAIN OFFICE: (618) 692-7478 MORGUE: (618) 296-4525 FAX: (618) 692-6042 FAX: (618) 692-9304 STEPHEN P. NONN OFFICE OF THE CORONER MADISON COUNTY, ILLINOIS 157 MAIN STREET SUITE 354 EDWARDSVILLE, IL. 62025-1962
More informationLCD L B-type Natriuretic Peptide (BNP) Assays
LCD L30559 - B-type Natriuretic Peptide (BNP) Assays Contractor Information Contractor Name: Novitas Solutions, Inc. Contractor Number(s): 12501, 12502, 12101, 12102, 12201, 12202, 12301, 12302, 12401,
More informationCoding Guidance for HIV Clinical Practices: Diagnosis Coding for HIV Patients
Coding Guidance for HIV Clinical Practices: Diagnosis Coding for HIV Patients This module discusses diagnosis coding used by medical practices when treating patients with HIV. Diagnosis coding establishes
More informationRADIATION THERAPY SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL
RADIATION THERAPY SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL APRIL 2018 CSHCN PROVIDER PROCEDURES MANUAL APRIL 2018 RADIATION THERAPY SERVICES Table of Contents 34.1 Enrollment......................................................................
More informationJAWDA Performance Quarterly KPI Profile (Clinic & Centers) March 2018
JAWDA Performance KPI Profile (Clinic & Centers) March 2018 1 P a g e Introduction: Physician office, clinic, and healthcare centers provide primary care function including health education, prevention,
More informationSubject Cancers in Firefighters and Fire Investigators
If a firefighter or a fire investigator is diagnosed with a prescribed on or after January 1, 1960, and meets the employment duration and additional criteria for the prescribed, then the disease is presumed
More information32 CFR (a)(4), (a)(6)(iii), and (a)(6)(iv)
CHAPTER 15 SECTION 1 ISSUE DATE: November 6, 2007 AUTHORITY: 32 CFR 199.14(a)(4), (a)(6)(iii), and (a)(6)(iv) I. APPLICABILITY This policy is mandatory for the reimbursement of services provided either
More informationTexas Chronic Disease Burden Report. April Publication #E
Texas Chronic Disease Burden Report April 2010 Publication #E81-11194 Direction and Support Lauri Kalanges, MD, MPH Medical Director Health Promotion and Chronic Disease Prevention Section, Texas Department
More informationTruman Medical Center-Hospital Hill Cancer Registry 2014 Statistical Summary Incidence
Truman Medical Center-Hospital Hill Cancer Registry 2014 Statistical Summary Incidence In 2014, there were 452 new cancer cases diagnosed and or treated at Truman Medical Center- Hospital Hill and an additional
More informationIntensive Behavioral Therapy for Obesity Guidelines
Health First Technologies Inc. dba Renua Medical 777 E. William Street, Suite 210 Carson City, NV 89701 877-885-1258 775-546-6156 E-fax www.renuamedical.com Intensive Behavioral Therapy for Obesity Guidelines
More informationRadiation Therapy Services
Radiation Therapy Services Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................
More informationTN Bundled Payment Initiative: Overview of Episode Risk Adjustment
TN Bundled Payment Initiative: Overview of Episode Risk Adjustment Amerigroup, April 2014 The State of Tennessee has implemented an episode-based approach to reimburse providers for the care delivered
More informationComprehensive cancer cover
Retirement Investments Insurance Health Comprehensive cancer cover Life Insurance+ with critical illness and Critical Illness+ Cancer is one of the biggest fears for the British public This is why our
More informationIcd10 presence of heart stent Displacement of coronary artery bypass graft, initial encounter. PMH shows severe O2 dependent COPD, with type II
Icd10 presence of heart stent Displacement of coronary artery bypass graft, initial encounter. PMH shows severe O2 dependent COPD, with type II diabetes mellitus secondary to chronic prednisone therapy,
More informationComparison of Medicare Fee-for-Service Beneficiaries Treated in Ambulatory Surgical Centers and Hospital Outpatient Departments
Comparison of Medicare Fee-for-Service Beneficiaries Treated in Ambulatory Surgical Centers and Hospital Outpatient Departments Prepared for: American Hospital Association April 4, 2019 Berna Demiralp,
More informationICD-9-CM Diagnosis Code options
ICD-9-CM Diagnosis Code options Diagnosis codes are used by both physicians and facilities to document the indication for the procedure. Intrathecal drug delivery is directed at managing chronic, intractable
More informationSupplementary Online Content
Supplementary Online Content Dharmarajan K, Wang Y, Lin Z, et al. Association of changing hospital readmission rates with mortality rates after hospital discharge. JAMA. doi:10.1001/jama.2017.8444 etable
More informationArkansas Blue Cross and Blue Shield (ABCBS) Patient Centered Medical Home (PCMH) Specifications Manual
Arkansas Blue Cross and Blue Shield (ABCBS) Patient Centered Medical Home (PCMH) Specifications Manual 2017 This document is a guide to the 2017 Arkansas Blue Cross and Blue Shield Patient-Centered Medical
More informationWASHINGTON perspectives
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg CMS Announces Final Inpatient Psychiatric Facilities PPS Update for FY 2017 The Centers for Medicare and Medicaid Services (CMS)
More informationNorth Carolina Inpatient Hospital Discharge Data - Data Dictionary FY 2016 Alphabetic List of Variables and Attributes Standard Research File
North Carolina Inpatient Hospital Discharge Data - Data Dictionary FY 2016 Alphabetic List of Variables and Attributes Standard Research File For a standard research file request one of three variables
More informationUS ARMY Public Health Command
US ARMY Public Health Command Morbidity Burdens, Army Non-Active Duty Beneficiaries, 2012 Photo graphic using models Approved for public release; distribution unlimited. ii TABLE OF CONTENTS BACKGROUND...1
More informationImpact and implications of Cancer Death Status Reporting Delay on Population- Based Relative Survival Analysis with Presumed-Alive Assumption
Impact and implications of Cancer Death Status Reporting Delay on Population- Based Relative Survival Analysis with Presumed-Alive Assumption X Dong, Y Ren, R Wilson, and K Zhang NAACCR 6-20-2017 Introduction
More informationValue of Hospice Benefit to Medicaid Programs
One Pennsylvania Plaza, 38 th Floor New York, NY 10119 Tel 212-279-7166 Fax 212-629-5657 www.milliman.com Value of Hospice Benefit May 2, 2003 Milliman USA, Inc. New York, NY Kate Fitch, RN, MEd, MA Bruce
More informationApril 7, Introduction
April 7, 2017 ICD-10 Coordination and Maintenance Committee Department of Health and Human Services Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244-1850 ICDProcedureCodeRequest@cms.hhs.gov
More informationCancer in Estonia 2014
Cancer in Estonia 2014 Estonian Cancer Registry (ECR) is a population-based registry that collects data on all cancer cases in Estonia. More information about ECR is available at the webpage of National
More information4100: Cellular Therapy Essential Data Follow-Up Form
4100: Cellular Therapy Essential Data Follow-Up Form Registry Use Only Sequence Number: Date Received: Key Fields CIBMTR Center Number: Event date: Visit: 100 day 6 months 1 year 2 years >2 years, Specify:
More informationVolume 2: ESRD Analytical Methods
Volume 2: ESRD Analytical Methods Table of Contents Volume 2: ESRD Analytical Methods... 545 Introduction 547 Data Sources 547 History of CMS Data Collection... 547 CROWNWeb... 548 CMS Medicare Enrollment
More informationNational Cancer Statistics in Korea, 2014
National Cancer Statistics in Korea, 2014 2016. 12. 20. Korea Central Cancer Registry Cancer Incidence in Korea, 2014 National Cancer Incidence, 2014 Trends in Cancer Incidence by Sex and Year * Dark colored
More informationSupplementary Online Content
Supplementary Online Content Acuna SA, Fernandes KA, Daly C, et al. Cancer mortality among recipients of solidorgan transplantation in Ontario, Canada. JAMA Oncol. Published online January 7, 2016. doi:10.1001/jamaoncol.2015.5137
More informationSchedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018 Payment for Services Covered Services are reimbursed based on the Allowable Charge. Blue Cross
More informationEstimated Minnesota Cancer Prevalence, January 1, MCSS Epidemiology Report 04:2. April 2004
MCSS Epidemiology Report 04:2 Suggested citation Perkins C, Bushhouse S.. Minnesota Cancer Surveillance System. Minneapolis, MN, http://www.health.state.mn.us/divs/hpcd/ cdee/mcss),. 1 Background Cancer
More informationCommunity Health Assessment Ontario County Chronic Diseases
2010-13 Community Health Assessment Ontario Chronic Diseases Chronic diseases, such as heart disease, diabetes and cancer, did not rank in the overall top 25 personal, community or unmet needs in the survey
More informationSchedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018 Payment for Services Covered Services are reimbursed based on the Allowable Charge. Blue Cross
More informationQBPC Claims Based Provider Quick Reference Guide
QBPC Claims Based Provider Quick Reference Guide Category: Diabetes Chronic Suite ICD-10-CM diagnosis HbA1c Test Codes LOINC Evidence of Treatment for Nephropathy Codes E10; E11; E13 83036-37 17856-6,
More informationPolicy Brief June 2014
Policy Brief June 2014 Which Medicare Patients Are Transferred from Rural Emergency Departments? Michelle Casey MS, Jeffrey McCullough PhD, and Robert Kreiger PhD Key Findings Among Medicare beneficiaries
More information1-844-FAX-A360 ( )
1-844-ASK-A360 (1-844-275-2360) 1-844-FAX-A360 (1-844-329-2360) www.myaccess360.com For more information, call AstraZeneca Access 360 at 1-844-ASK-A360, Monday through Friday, 8 am to 8 pm ET. IMFINZI
More informationChapter 6: Healthcare Expenditures for Persons with CKD
Chapter 6: Healthcare Expenditures for Persons with CKD In this 2017 Annual Data Report (ADR), we introduce information from the Optum Clinformatics DataMart for persons with Medicare Advantage and commercial
More informationSKCC Protocol Review Committee New Study Application
Instructions: Submit the following documents to prc@jefferson.edu - Completed New Study Application (aka MCSF) - Protocol - Protocol Facilitation Committee Approval (if applicable) - MDG Priority Score
More informationCancer in Rural Illinois, Incidence, Mortality, Staging, and Access to Care. April 2014
Cancer in Rural Illinois, 1990-2010 Incidence, Mortality, Staging, and Access to Care April 2014 Prepared by Whitney E. Zahnd, MS Research Development Coordinator Center for Clinical Research Southern
More information