SUPPLEMENTAL MATERIAL

Transcription

1 SUPPLEMENTAL MATERIAL

2 Table S1: Codes used to identify acute care services Service Source Code and Description Cardiac TROPONIN QUAL Biomarkers TROPONIN QN Cardiology in Taxonomy Code 207RC0000X-Internal Medicine, Cardiovascular Disease Emergency Taxonomy Code 207RI0011X-Interventional Cardiology Department Premier Admitting 4011-Cardiovascular Diseases (CD) Chest Pain Unit G0378-Hospital observation service, per hour G0379-Direct referral for hospital observation care Medicare Revenue 0762-Treatment or observation room-observation room (eff 9/93) OBSERVATION ADDL HR OBSERVATION CCU HRS INITIAL OBSERVATION PER DAY HIGH COMPLEXITY OBSERVATION 23 HR PER HR OBSERVATION 1ST HR OBSERVATION 23 HR INITIAL OBSERVATION PER DAY MODERATE COMPLEXITY OBSERVATION CCU PER HR OBSERVATION CCU FLAT RATE OBSERVATION 23 HR OBSERVATION CCU 7-11 HRS OBSERVATION CCU 0-6 HRS INITIAL OBSERVATION PER DAY LOW COMPLEXITY OBSERVATION 23 HR 0-8 Dedicated Medicare Revenue 0450-Emergency room- general classification Emergency Medicare Revenue 0451-Emergency Room: EM/EMTALA Department Medicare Revenue 0452-Emergency Room: ER/Beyond EMTALA Medicare Revenue 0456-Emergency Room: Urgent care Medicare Revenue 0459-Emergency Room: Other emergency room Medicare Revenue Professional fees- emergency room Premier Department 450-Emergency Room codex Emergency Taxonomy Code 207P00000X-Emergency Medicine Department Specialist Taxonomy Code 207PE0004X-Emergency Medicine, Emergency Medical Services Premier Admitting 4028-Emergency Medicine (EM) Pathology Medicare Revenue 0305-Laboratory- hematology Medicare Revenue 0310-Laboratory pathological- general classification Thrombolysis THROMBOLYSIS CORONARY IV INFUSION Primary Percutaneous Coronary Could not be identified using administrative data Intervention

3 Table S2: Codes used to identify diagnostic and procedural services Service Source Code and Description Cardiac Nuclear Perfusion Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest and or stress (exercise or pharmacologic Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Myocardial imaging, infarct avid, planar; qualitative or quantitative Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification Cardiac blood pool imaging, gated equilibrium,

4 SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique NM MYOCARD PERF SINGL SPECT W/WALL,EF,REST/STRESS NM MYOCARD PERF MULTI SPECT W/WALL,EF,REST/STRESS NM MYOCARD PERF SINGL PLANR W/WALL,EF,REST/STRESS NM MYOCARD PERF MULTI PLANR W/WALL,EF,REST/STRESS NM CARDIOVASCULAR HEMODYNAMICS NM MYOCARD PERF SINGLE NM MYOCARD PERF MULTI NM MYOCARD PERF SINGLE SPECT NM MYOCARD PERF MULTI SPECT NM MYOCARD INFARCT NM MYOCARD INFARCT W/EJECTION FRACTION 1ST PASS NM MYOCARD INFARCT SPECT NM CARDIAC BLOOD POOL SINGLE NM CARDIAC BLOOD POOL MULTI NM MYOCARD PERF WALL MOTION NM MYOCARD PERF EJECTION FRACTION NM CARDIAC 1ST PASS SINGLE NM CARDIAC 1ST PASS MULTI NM MUGA AT REST W/SPECT NM MUGA SINGLE W/RIGHT VENTRICULAR EF BY 1ST PASS Chest X-Ray Routine chest x-ray, so described Other chest x-ray Radiologic examination, chest; single view, frontal Radiologic examination, chest; stereo, frontal Radiologic examination, chest, 2 views, frontal and lateral; Radiologic examination, chest, 2 views, frontal and lateral; with apical lordotic procedure Radiologic examination, chest, 2 views, frontal and lateral; with oblique projections Radiologic examination, chest, 2 views, frontal and lateral; with fluoroscopy

5 Coronary Artery Bypass Grafting (CABG) Radiologic examination, chest, complete, minimum of 4 views; Radiologic examination, chest, complete, minimum of 4 views; with fluoroscopy Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies) XR CHEST 1 VIEW XR CHEST 1 VIEW PA XR CHEST 1 VIEW PORTABLE XR CHEST 1 VIEW AP XR CHEST LORDOTIC 1 VIEW XR CHEST STEREO XR CHEST 2 VIEWS XR CHEST OBLIQUE 2 VIEWS XR CHEST FLAT & UPRIGHT XR CHEST 2 VIEWS PORTABLE XR CHEST 2 VIEWS W/APICAL LORDOTIC XR CHEST W/OBLIQUES XR CHEST COMPLETE 4+ VIEWS XR CHEST SPECIAL VIEWS PF XR CHEST 1 VIEW PF XR CHEST STEREO PF XR CHEST 2 VIEWS PF XR CHEST 2 VIEWS W/APICAL LORDOTIC PF XR CHEST W/OBLIQUES PF XR CHEST COMPLETE 4+ VIEWS PF XR CHEST COMPLETE 4+ VIEWS PF XR CHEST SPECIAL VIEWS CHEST XRAY RESULTS DOCUMENT & REVIEW Aortocoronary bypass for heart revascularization, not otherwise specified (Aorto)coronary bypass of one coronary artery (Aorto)coronary bypass of two coronary arteries (Aorto)coronary bypass of three coronary arteries (Aorto)coronary bypass of four or more coronary arteries Single internal mammary-coronary artery bypass Double internal mammary-coronary artery bypass Abdominal-coronary artery bypass Other bypass anastomosis for heart revascularization Coronary artery bypass, vein only; single coronary venous graft Coronary artery bypass, vein only; 2 coronary venous grafts

6 33512-Coronary artery bypass, vein only; 3 coronary venous grafts Coronary artery bypass, vein only; 4 coronary venous grafts Coronary artery bypass, vein only; 5 coronary venous grafts Coronary artery bypass, vein only; 6 or more coronary venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation Coronary artery bypass, using arterial graft(s); single arterial graft Coronary artery bypass, using arterial graft(s); 2 arterial grafts Coronary artery bypass, using arterial graft(s); 3 arterial grafts Coronary artery bypass, using arterial graft(s); 4 arterial grafts ENDARTERECTOMY CORONARY OPEN ER CABG VEIN 1 GRAFT ER CABG VEIN 2 GRAFTS ER CABG VEIN 3 GRAFTS ER CABG VEIN 4 GRAFTS ER CABG VEIN 5 GRAFTS ER CABG VEIN > 6 GRAFTS ER CABG ARTERY/VEIN 1 GRAFT ER CABG ARTERY/VEIN 2 GRAFTS ER CABG ARTERY/VEIN 3 GRAFTS ER CABG ARTERY/VEIN 4 GRAFTS ER CABG ARTERY/VEIN 5 GRAFTS ER CABG ARTERY/VEIN >6 GRAFTS ER REOPERATION CORONARY ARTERY BYPASS ER CABG ARTERIAL 1 GRAFT ER CABG ARTERIAL 2 GRAFTS

7 Coronary CT Angiogram ER CABG ARTERIAL 3 GRAFTS ER CABG ARTERIAL > 4 GRAFTS PF CABG VEIN 1 GRAFT PF CABG VEIN 2 GRAFTS PF CABG VEIN 3 GRAFTS PF CABG VEIN 4 GRAFTS PF CABG VEIN 5 GRAFTS PF CABG VEIN > 6 GRAFTS PF CABG ARTERY/VEIN 1 GRAFT PF CABG ARTERY/VEIN 2 GRAFTS PF CABG ARTERY/VEIN 3 GRAFTS PF CABG ARTERY/VEIN 4 GRAFTS PF CABG ARTERY/VEIN 5 GRAFTS PF CABG ARTERY/VEIN > 6 GRAFTS PF REOPERATION CORONARY ARTERY BYPASS PF CABG ARTERIAL 1 GRAFT PF CABG ARTERIAL 2 GRAFTS PF CABG ARTERIAL 3 GRAFTS PF CABG ARTERIAL > 4 GRAFTS PACK CABG CATHETER CABG IMA GRAFT PERFORMED PRIMARY ISOLATED CABG Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed) Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) Computer tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed) CTA HEART CORONARY ARTERIES ONLY CTA HEART CORONARY ARTERIES & CALCIUM SCORING CTA HEART CORONARY ARTERIES & MORPHOLOGY CTA HEART CORONARIES, MORPH & CALCIUM SCORING

8 Diagnostic Coronary Angiography CT HEART RVEF/LVEF AND WALL MOTION CTA HEART ARTERIES,GRAFTS,STRUCT/MORPH W/CONTRAST Left heart cardiac catheterization Combined right and left heat cardiac catheterization Angiocardiography, not otherwise specified Angiocardiography of right heart structures Angiocardiography of left heart structures Combined right and left heart angiogcardiography Coronary arteriography using a single catheter Coronary arteriography using two catheters Other and unspecified coronary arteriography Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial venous grafts) including intraprocedural injection(s) for bypass graft angiography Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural

9 injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography Catheter placement in coronary artery(s), arterial coronary conduit(s), and/or venous coronary bypass graft(s) for coronary angiography without concomitant left heart catheterization Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; by cutdown Combined right heart catheterization and retrograde left heart catheterization Combined right heart catheterization with left ventricular puncture (with or without retrograde left heart catheterization Combined right heart catheterization and left heart catheterization through existing septal opening (with or without retrograde left heart catheterization) Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; ventricular and/or atrial angiography Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits CATHETER ANGIOGRAM CATHETER ANGIOGRAM 7FR 110CM CATHETER ANGIOGRAM 7FR

10 90CM CATHETER ANGIOGRAM 8FR 110CM CATHETER ARTERIOGRAM CATHETER CARDIAC DIAGNOSTIC CATH PLACEMENT FOR CORONARY ANGIOGRAM CATH LEFT HEART W/LVA CATH LEFT HEART W/LVA & CA CATH LEFT HEART W/LVA CA & AO CATH LEFT HEART W/LVA CA & BG CATH LEFT HEART W/LVA CA BG & AO CATH PLACE FOR CORONARY ANGIO W/O LEFT HEART CATH Electrophysiology (EP) Ablation Excision or destruction of other lesion or tissue of heart, endovascular approach Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathways, accessory atrioventricular connections or other atrial foci, singly or in combination Intracardiac catheter ablation of arrhythmogenic focus; for treatment of ventricular tachycardia Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation ABLATION SVT ABLATION AV ABLATION VT EP Testing Catheter based invasive electrophysiologic testing Cardiac mapping Bundle of His recording Intra-arterial recording Right ventricular recording Intraventricular and/or intra-arterial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia Intra-arterial pacing

11 Exercise Stress Testing Intraventricular pacing Intracardiac electrophysiologic 3-dimensional mapping Esophageal recording of atrial electrogram with or without ventricular electrogram(s) with pacing Induction of arrhythmia by electrical pacing Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording Programmed stimulation and pacing after intravenous drug infusion Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction EP COMPREHENSIVE W/ARRHYTHMIA LEFT VENTRICULAR RECORDING EP COMPREHENSIVE LEFT VENTRICLE RIGHT VENTRICULAR RECORDING INTRA-ATRIAL RECORDING EP COMPREHENSIVE LEFT ATRIUM INTRAVENTRICULAR PACING EP INTRACARDIAC 3-D MAPPING TACHYCARDIA SITE MAPPING INTRA-ATRIAL PACING Cardiovascular stress test using treadmill Masters' two-step stress test

12 General Computed Tomography (CT) Cardiovascular stress test using bicycle ergometer Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring and/or pharmacological stress: with supervision, interpretation and report Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring and/or pharmacological stress; with supervision, without interpretation and report Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring and/or pharmacological stress; with tracing only, without interpretation and report Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring and/or pharmacological stress: with interpretation and report only STRESS TEST COMPLETE W/PF STRESS TEST W/ERGOMETER STRESS TEST TREADMILL Computerized axial tomography of head Other tomography of head Computerized axial tomography of thorax Other Tomography of Thorax Computerized axial tomography of kidney Computerized axial tomography of abdomen Other abdomen tomography Other computerized axial tomography Computed tomography, head or brain; without contrast material Computed tomography, head or brain; with contrast material Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections Computed tomography, thorax; without contrast material Computed tomography, thorax; with contrast material(s) Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing Computed tomography, pelvis; without contrast material Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further

13 sections Computed tomography, abdomen; without contrast material Computed tomography, abdomen; with contrast material(s) Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections CT CHEST W/O CONTRAST CT CHEST W/O CONTRAST EXTENDED CT CHEST W/CONTRAST CT CHEST W/CONTRAST EXTENDED CT CHEST W/ & W/O CONTRAST CT CHEST W/ & W/O CONTRAST EXTENDED CTA CHEST (NONCARD) W/ CONTRAST & W/O IF PERFORMED CT ABDOMEN W/CONTRAST CT ABDOMEN W/CONTRAST EXTENDED CT ABDOMEN W/O CONTRAST CT ABDOMEN W/ & W/O CONTRAST EXTENDED CT ABDOMEN W/ & W/O CONTRAST CT ABDOMEN W/O CONTRAST EXTENDED CT ABDOMEN W/O CONTRAST LIMITED CT HEAD/BRAIN W/CONTRAST CT HEAD/BRAIN W/O CONTRAST EXTENDED CT HEAD/BRAIN W/O CONTRAST CT HEAD/BRAIN W/ & W/O CONTRAST EXTENDED CT HEAD/BRAIN W/CONTRAST EXTENDED CT HEAD/BRAIN W/ & W/O CONTRAST CTA,ABD & PELVIS,W/CONT INCLUDE W/O IMAGES,IF PERF CTA PELVIS W/ CONTRAST & W/O IF PERFORMED CTA ABDOMEN W/ CONTRAST & W/O IF PERFORMED CTA HEAD W/ CONTRAST & W/O IF PERFORMED CT PELVIS W/O CONTRAST

14 Percutaneous Coronary Intervention (PCI) CT PELVIS W/ & W/O CONTRAST EXTENDED CT PELVIS W/CONTRAST EXTENDED CT PELVIS W/ & W/O CONTRAST CT PELVIS W/CONTRAST CT PELVIS W/O CONTRAST EXTENDED 0.66-Percutaneous transluminal coronary angioplasty [PTCA] Insertion of non-drug-eluting coronary artery stent(s) Insertion of drug-eluting coronary artery stent(s) Percutaneous transluminal coronary angioplasty; single major coronary artery or branch Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; each additional vessel Percutaneous transluminal coronary balloon angioplasty; single vessel percutaneous transluminal coronary balloon angioplasty; each additional vessel Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; single vessel Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; each additional vessel CATHETER ATHERECTOMY (CUTTING BALLOON) CATHETER BALLOON ACE CATHETER BALLOON ACE LONG CATHETER BALLOON ANGIOGRAM CATHETER BALLOON ARC CATHETER BALLOON ASSIST CATHETER BALLOON BAILOUT CATH LAB

15 CATHETER BALLOON BANDIT CATHETER BALLOON COBRA CATHETER BALLOON DILATION CARDIAC CATHETER BALLOON ELIPSE CATHETER BALLOON EVERGREEN CATHETER BALLOON GRAFT ACE CATHETER BALLOON GRUNTZIG CATHETER BALLOON MEDITECH CATHETER BALLOON MILLENIA CATHETER BALLOON MONGOOSE CATHETER BALLOON NC RANGER CATHETER BALLOON PERC CATHETER BALLOON PMC CATHETER BALLOON PREDATOR CATHETER BALLOON PRISM CATHETER BALLOON PROBE CATHETER BALLOON PTCA CATHETER BALLOON RALLY CATHETER BALLOON RANGER CATHETER BALLOON RX COMET CATHETER BALLOON RX COMET VP CATHETER BALLOON SAVVY CATHETER BALLOON SLALOM CATHETER BALLOON SURPASS CATHETER BALLOON THOR CATHETER BALLOON TITAN CATHETER BALLOON TITAN MEGA CATHETER BALLOON TRAKSTAR CATHETER BALLOON TRAPPER CATHETER BALLOON TX CATHETER BALLOON ULTRA THICK CATHETER BALLOON VALOR CATHETER BALLOON VALVULOPLASTY CATHETER GUIDING PTCA CONNECTOR PTCA GUIDEWIRE PTCA GUIDEWIRE PTCA STEERABLE INTRODUCER PTCA INTRODUCER STENT SET KIT PTCA KIT PTCA GUIDEWIRE PACK CATHETERIZATION LAB

16 Permanent Pacemaker (PPM)/ Automatic Implantable Cardioverter Defibrillator STENT CORONARY STENT INTRACORONARY CATHETER BALLOON DISPATCH CATHETER BALLOON LIFESTREAM CATHETER BALLOON MAGNUM CATHETER BALLOON UT 8MMX CATHETER BALLOON BANDIT 3.75 NC CATHETER BALLOON CATHETER BALLOON 2.5M CATHETER BALLOON 3.0M CATHETER BALLOON 3.5MM CATHETER BALLOON 4MX2CM CATHETER BALLOON 5FR 4X CATHETER BALLOON 5FR CATHETER BALLOON 6MM CATHETER BALLOON 6X CATHETER BALLOON 6X CATHETER BALLOON 7X CATHETER BALLOON 8FR CATHETER BALLOON BMX 10X STENT DRUG ELUTING STENT CORDIS CYPHER DRUG ELUTING STENT TAXUS EXPRESS PACLITAXEL-ELUTING STENT MEDTRONIC ENDEAVOR STENT CORONARY WITH DELIVERY SYSTEM PTCA W/STENT EACH ADDL VESSEL PTCA W/STENT SINGLE VESSEL PTCA W/SUPPLIES PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY STENT PLACEMENT SINGLE VESSEL STENT PLACEMENT EACH ADDL VESSEL PTCA SINGLE VESSEL PTCA EACH ADDL VESSEL Implantation of cardiac resynchronization pacemaker without mention of defibrillation, total system (CRT-P) Implantation of cardiac resynchronization defibrillator, total system (CRT-D) Implantation of replacement of transvenous lead (electrode) into left ventricular coronary venous system Implantation or replacement of cardiac

17 (AICD) Implantation resynchronization pacemaker pulse generator only (CRT-P) Implantation or replacement of cardiac resynchronization defibrillator pulse generator device only (CRT-D) Insertion of permanent pacemaker, initial or replacement, type of device not specified Replacement of any type pacemaker device with single-chamber device, not specified as rate responsive Replacement of any type of pacemaker device with single-chamber device, rate responsive Replacement of any type pacemaker device with dual-chamber device Revision or removal of pacemaker device Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial Insertion or replacement of permanent pacemaker with transvenous electrode(s); ventricular Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular Insertion or replacement of pacemaker pulse generator only;dual chamber Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator) Repositioning of previously implanted transvenous pacemaker or pacing cardioveter-defibrillator (right atrial or right ventricular) electrode Insertion of a single transvenous electrode, permanent pacemaker or cardioverter-defibrillator Insertion of 2 transvenous electrodes, permanent pacemaker or cardioverter-defibrillator Repair of single transvenous electrode for a single chamber, permanent pacemaker or single chamber pacing cardioverter-defibrillator Repair of 2 transvenous electrodes for a dual chamber permanent pacemaker or dual chamber pacing cardioverter-defibrillator Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or pacing cardioverterdefibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of generator) Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of pacing cardioverter-defibrillator or pacemaker pulse generator (including upgrade to dual chamber system)

18 33226-Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of generator) Insertion of single or dual chamber pacing cardioverter-defibrillator pulse generator Insertion or repositioning of electrode lead(s) for single or dual chamber pacing cardioverter-defibrillator and insertion of pulse generator ER INSERTION PACEMAKER VENTRICULAR INSERTION PACEMAKER VENTRICULAR INSERTION PACEMAKER THORACOTOMY OP INSERTION PACEMAKER XYPHOID OP ER INSERTION PACEMAKER ATRIAL & VENTRICULAR INSERTION PACEMAKER THORACOTOMY ER INSERTION PACEMAKER THORACOTOMY INSERTION PULSE GENERATOR SINGLE INS OF PAC CARDIOVERT-DEFIB PULSE GEN;W/EXIST MULT ER INSERTION ICD PULSE GENERATOR INSERTION ICD PULSE GENERATOR INSERTION ICD LEAD W/PULSE GENERATOR OP INSERTION PULSE GENERATOR DUAL ER INSERTION PULSE GENERATOR DUAL ER REPAIR ICD PULSE GENERATOR UPGRADE IMPLANTED PACEMAKER ER UPGRADE IMPLANTED PACEMAKER INSERTION PACEMAKER XYPHOID INSERTION PULSE GENERATOR DUAL OP INSERTION PACEMAKER ATRIAL & VENTRICULAR OP INSERT PACING ELECT AT SAME TIME INSERT PM

19 Stress Echocardiography ER INSERTION PULSE GENERATOR SINGLE INSERTION ICD LEAD W/PULSE GENERATOR INS PCMKR PULSE GENERATOR; W/EXISTING MULT LEADS ER INSERTION ICD LEAD OTHER THAN THORACOTOMY INSERTION ICD LEAD OTHER THAN THORACOTOMY REPAIR ICD PULSE GENERATOR INSERTION PACEMAKER ATRIAL OP ER INSERTION ICD LEAD W/PULSE GENERATOR INS OF PAC CARDIOVERTER- DEFIB PUL GEN;W/EXIST DUAL INSERTION PACEMAKER ATRIAL & VENTRICULAR REPAIR ICD PULSE GENERATOR OP UPGRADE IMPLANTED PACEMAKER OP INSERTION ICD LEAD OTHER THAN THORACOTOMY OP INSERTION PACEMAKER VENTRICULAR OP INSERTION ICD PULSE GENERATOR OP INSERTION PACEMAKER ATRIAL INSERT PACING ELECT W ATTACH PREV IMPL PM ER INSERTION CARDIAC ELECTRODE SINGLE INSERTION PULSE GENERATOR SINGLE OP ER INSERTION PACEMAKER ATRIAL ER INSERTION PACEMAKER XYPHOID Echocardiography, transthoracic, real-time with image documentation (2D), with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise, and/or pharmacologically induced stress, with interpretation and report Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise, and/or pharmacologically induced stress, with interpretation and report; including

20 performance of continuous electrocardiographic monitoring, with physician supervision PF ECHO REST & STRESS W/PF PF ECHO REST & STRESS W/PF & CONTINUED EKG MONITOR ECHO REST & STRESS W/PF ECHO REST & STRESS W/PF & CONTINUOUS EKG MONITOR Table S3: Codes used to identify inpatient management services Service Source Code and Description Coronary Care Medicare Revenue 0210-General classification Unit Medicare Revenue 0211-Coronary care- myocardial infraction Medicare Revenue 0212-Coronary care-pulmonary care Medicare Revenue 0213-Coronary care- heart transplant Medicare Revenue 0219-Coronary care- other coronary care R&B CVICU R&B CVICU ISOLATION R&B CICU/CCU (CORONARY CARE) R&B CICU/CCU ISOLATION (CORONARY CARE) Coronary Step Down Unit Medicare Revenue 0214-Coronary care- post CCU; redefined as intermediate CCU R&B STEP DOWN CVICU ISOLATION R&B STEP DOWN ALL INCLUSIVE R&B TELEMETRY DELUXE R&B TCU ISOLATION R&B STEP DOWN CVICU DELUXE R&B STEP DOWN CVICU SEMI PRIVATE R&B STEP DOWN CVICU PRIVATE R&B STEP DOWN CICU/CCU SEMI PRIVATE R&B TCU SEMI PRIVATE R&B TELEMETRY WARD R&B TCU ALL INCLUSIVE R&B STEP DOWN CICU/CCU PRIVATE R&B STEP DOWN CICU/CCU ISOLATION R&B STEPDOWN ISOLATION R&B STEP DOWN MICU SEMI PRIVATE R&B TCU WARD R&B STEP DOWN MICU ISOLATION

21 R&B TCU PRIVATE R&B TELEMETRY SEMI PRIVATE R&B STEP DOWN SEMI PRIVATE R&B TELEMETRY ALL INCLUSIVE R&B STEP DOWN MICU DELUXE R&B TELEMETRY PRIVATE R&B STEP DOWN DELUXE R&B STEP DOWN MICU PRIVATE R&B STEP DOWN PRIVATE R&B STEP DOWN CICU/CCU DELUXE R&B TELEMETRY ISOLATION R&B TCU DELUXE Inpatient Cardiac Surgical Service Taxonomy Code 208G00000X-Thoracic Surgery (Cardiothoracic Vascular Surgery) Premier Admitting 4012-Cardiovascular Surgery (CDS) Inpatient Taxonomy Code 207RC0000X-Internal Medicine, Cardiovascular Disease Cardiology Taxonomy Code 207RC0001X-Clinical Cardiatric Electrophysiology Service Taxonomy Code 207RI0011X-Interventional Cardiology Premier Admitting 4010-Cardiac Electrophysiology (ICE) Premier Admitting 4011-Cardiovascular Diseases (CD) Intensive Care Non-invasive mechanical ventilation Unit Continuous invasive mechanical ventilation of unspecified duration Continuous invasive mechanical ventilation for less than 96 consecutive hours Continuous invasive mechanical ventilation for 96 consecutive hours or more Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day ; hospital inpatient/observation, each subsequent day ; nursing facility, per day Continuous negative pressure ventilation (CNP), initiation and management Medicare Revenue 0200-Intensive care- General classification Medicare Revenue 0206-Intensive care- Post ICU Medicare Revenue 0209-Intensive care- Other intensive care R&B ICU R&B ICU ISOLATION R&B MICU ISOLATION R&B MICU Inpatient Internal Taxonomy Code 207R00000X-Internal Medicine Medicine Service Taxonomy Code 208M00000X-Hospitalist Premier Admitting 4046-Hospitalist (HOS) Premier Admitting 4050-Internal Medicine (IM) Transplant Unit Combined heart-lung transplantation Heart transplantation

22 Medicare Revenue Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation Heart-lung transplant with recipient cardiectomypneumonectomy Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation Heart transplant, with or without recipient cardiectomy 0213-Coronary care- heart transplant HEART/LUNG TRANSPLANT W/RECIPIENT HEART TRANSPLANT OP HEART/LUNG TRANSPLANT W/RECIPIENT OP HEART TRANSPLANT Table S4: Codes used to identify secondary prevention services Service Source Code and Description Inpatient Cardiac Cardiac retraining Rehabilitation (phase I) Medicare Revenue Outpatient Cardiac Rehabilitation (phase II or III) Medicare Revenue 0943-Other therapeutic services- cardiac rehabilitation CARDIAC REHAB THERAPY CARDIAC REHAB W/O MONITOR PER SESSION CARDIAC REHAB W/MONITOR PER SESSION CARDIAC REHAB W/MONITOR PER MONTH CARDIAC REHAB EVAL CARDIAC REHAB PROCEDURE UNLISTED CARDIAC REHAB CONSULT CARDIAC REHAB PHASE I PER SESSION CARDIAC REHAB EDUCATION CARDIAC REHAB MISC Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session) Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session) 0943-Other therapeutic services- cardiac rehabilitation CARDIAC REHAB PHASE III/MAINT PER MONTH CARDIAC REHAB PHASE II PER SESSION CARDIAC REHAB PHASE III/MAINT PER SESSION Pharmacist Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and

23 Physiotherapy/ Occupational Therapy Medicare Revenue intervention if provided; initial 15 minutes, new patient ; initial 15 minutes, established patient ; each additional 15 minutes 0250-Pharmacy- general classification MEDICATION THERAPY MGMT INIT 1ST 15MIN, NEW MEDICATION THERAPY MGMT EACH ADDL 15 MIN MEDICATION THERAPY MGMT 1ST 15MIN,EST Combined physical therapy without mention of the components Other physical therapy Occupational therapy Rehabilitation, not elsewhere classified Peripheral arterial disease (PAD) rehabilitation, per session Physical therapy evaluation Physical therapy re-evaluation Occupational therapy evaluation Occupational therapy re-evaluation Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing) Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion) Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes Therapeutic procedure(s), group (2 or more individuals) Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes OT WORK SIMULATION 1 HR OT FUNCTIONAL CAPACITY TEST ADDL HR OT CONFERENCE 20 MIN OT CONFERENCE 1 HR OT WORK CAPACITY ANALYSIS 15 MIN OT EVAL 30 MIN OT CONFERENCE 10 MIN OT RE-EVALUATION OT CONFERENCE FAMILY 15 MIN OT EVAL 15 MIN OT CHECK OT EVAL SCREENING 15 MIN OT MISC OT FUNCTIONAL CAPACITY TEST 30 MIN

24 OT IN ROOM VISIT OT CONFERENCE DISCHARGE 15 MIN OT EVALUATION OT EDUCATION 1 HR OT FUNCTIONAL CAPACITY TEST 1 HR OT FUNCTIONAL CAPACITY TEST 6 HRS OT RE-EVAL 15 MIN OT EVAL HOME 1 HR OT FUNCTIONAL CAPACITY TEST 2 HRS 30 MIN OT EVAL 20 MIN OT WORK SIMULATION 30 MIN OT CONFERENCE 15 MIN OT EDUCATION 15 MIN OT EVAL 45 MIN OT STERILE TECHNIQUE OT FOLLOWUP OT EVAL ISOKINETIC 15 MIN OT RE-EVAL 30 MIN OT EDUCATION FAMILY 15 MIN OT EVAL HOME 15 MIN OT CONFERENCE ADDL 15 MIN OT WORK SIMULATION GROUP 1 HR OT COMMUNITY REINTEGRATION OUTING 15 MIN OT HOME VISIT OT EVAL HAND THERAPY 15 MIN OT FUNCTIONAL CAPACITY TEST 15 MIN OT BTE/WORK SIMULATOR TEST 15 MIN OT EDUCATION GROUP 30 MIN OT EVAL 10 MIN OT EVAL ADDL 15 MIN OT CONFERENCE 30 MIN OT EDUCATION 30 MIN OT COMMUNITY/WORK REINTEGRATION 15 MIN OT EVAL PED 15 MIN OT WORK CAPACITY ANALYSIS 30 MIN OT SPECIAL REPORT 15 MIN OT EVAL 1 HR OT AIDE/ADDL PERSON OT WORK CAPACITY ANALYSIS ADDL 30 MIN OT WORK CAPACITY ANALYSIS 1 HR OT CONSULT 15 MIN OT EVAL WHEELCHAIR 15 MIN OT EVAL SENSORY 15 MIN OT EVAL DISABILITY 15 MIN OT WORK SIMULATION GROUP ADDL 30 MIN PT HOME INSTRUCTION/PROGRAM 15 MIN

25 Social Worker Behavior therapy PT CONFERENCE 1 HR PT EVAL PRE OP 15 MIN PT CONFERENCE 20 MIN PT EDUCATION FAMILY 15 MIN PT CONFERENCE DISCHARGE 15 MIN PT EDUCATION PATIENT 15 MIN PT AIDE/ADDL PERSON PT FUNCTIONAL CAPACITY TEST PER HR PT EVAL 30 MIN PT EDUCATION BACK CARE 15 MIN PT EVAL 45 MIN PT STAT FEE PT MISC PT CONFERENCE 45 MIN PT CONSULT 15 MIN PT EVAL 20 MIN PT EVAL 15 MIN PT EVAL ORTHOTIC 15 MIN PT CONFERENCE 10 MIN PT EVALUATION PT EQUIPMENT CHECK 15 MIN PT EVAL 1 HR PT FOLLOWUP PT HOME VISIT PT PERFORMANCE TEST 15 MIN PT RE-EVALUATION PT EVAL HOME 30 MIN PT CONFERENCE 15 MIN PT EVAL WHEELCHAIR 15 MIN PT RE-EVAL 30 MIN PT EVAL TENS 15 MIN PT CONFERENCE 30 MIN PT EDUCATION BACK CARE 1 HR PT EVAL ISOKINETIC 30 MIN PT EDUCATION PATIENT 30 MIN PT EVAL SCREENING 15 MIN PT IN ROOM VISIT PT RE-EVAL 15 MIN Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment ; re-assessment Health and behavior intervention, each 15 minutes, face-to-face; individual ; group (2 or more patients) ; family (with the patient present) ; family (without the patient present) SOCIAL SERVICES FLAT RATE

26 Inpatient Heart Failure Services Outpatient Heart Failure Services Readmissions Prevention Program Could not be identified using administrative data Could not be identified using administrative data Could not be identified using administrative data SOCIAL SERVICES 1 HR HOME HEALTH VISIT SOCIAL WORKER

27 Table S5: Percentage agreement and disagreement between administrative data (non-premier codes) and AHA Annual Survey Services recommended for AMI care Acute Care Dedicated Emergency Department (ED) Diagnostic and Procedural Cardiac Nuclear Perfusion Imaging General Computed Tomography (CT) Diagnostic Coronary Angiography Percutaneous Coronary Intervention (PCI) Electrophysiology (EP) Testing Inpatient Management Agree: Yes on AHA survey/ Yes on administrati ve data (%) % Agree or Disagree Disagree: Yes on AHA survey/ No on administrati ve data (%) Disagree: No on AHA survey/ Yes on administrati ve data (%) Agree: No on AHA survey/ No on administrati ve data (%) % Agreement Cohen s Kappa (95% CI) McNemar s test for symmetry P-value* N/A N/A N/A N/A ( , ) < (0.80, 0.93) (0.90, 0.98) (0.53, 0.68) <0.01 Coronary Care Unit (0.36, 0.54) <0.01

28 Inpatient Cardiac Surgical Service Inpatient Cardiology Service N/A N/A N/A N/A Intensive Care Unit (-0.19, 0.52) <0.01 Inpatient Internal Medicine Service N/A N/A Transplant Unit N/A N/A Secondary Prevention Inpatient Cardiac Rehabilitation (Phase 1) (0.25, 0.52) <0.01 Pharmacist N/A N/A Physiotherapy/ Occupational Therapy (-0.01, 0.19) Social Worker * Statistically significant at P<0.05 Agreement between AHA survey and non-premier codes (,, Medicare Revenue, Taxonomy) ( , ) <0.01