For version 200 apr drgs the standard risk of

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For version 20.0 APR-DRGs, the standard risk of mortality level was comprehensively reviewed for all secondary diagnoses codes. There were a number of revisions introduced, the majority of which were to lower the standard risk of mortality level. In situations where there was a great deal of variability within an ICD-9-CM diagnosis code, the approach was to lower the standard risk of mortality level and then in later steps of Phase I, consider whether modifications to the standard risk of mortality level are indicated based upon specific age ranges, APR-DRGs, or non-OR procedures. For version 20.0 APR-DRGs, there are a total of 12,988 ICD-9-CM diagnosis codes. These codes are assigned to the following risk of mortality levels: 10,473 minor, 1,564 moderate, 608 major, 343 extreme. Compared to version 15.0 APR-DRGs, there is a slightly higher proportion of sec- ondary diagnoses classified as minor and moderate risk of mortality diagnoses and a slightly lower proportion classified as major and moderate risk of mortality diagnoses. For version 20.0 APR-DRGs, there are 2,515 secondary diagnosis codes that are assigned a standard risk of mor- tality level of moderate, major, or extreme. This is just slightly more than half the 4,656 secondary diagnosis codes that are assigned a standard severity of illness level of moderate, major, or extreme. 3. Modify the standard risk of mortality level of a secondary diagnosis based on age The standard risk of mortality for certain secondary diagnoses may be modified depending upon the age of the patient. This age modification is applied much more extensively for risk of mortality, than for severity of illness. For pediatric patients, the standard risk of mortality level of secondary diagnoses is often decreased. For example, the risk of mortality level for diabetes with ketoacido- sis is lowered from moderate to minor for pediatric patients. It is also lowered for many other secondary diagnoses including infectious illnesses and traumatic injuries. However, for some pediatric diagnoses, mostly congenital anomalies, the risk of mortality level is increased during the neonatal time period and sometimes the first year of life. For example, the risk of mortality level for hypoplastic left heart syndrome is increased from major to extreme during the neonatal period; renal dysphasia is increased from moderate to major during the neonatal period; and con- genital tricuspid atresia/stenosis is increased from moderate to major during the first year of life.
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48 For elderly patients, the standard risk of mortality level is increased to a higher level for many sec- ondary diagnoses. Elderly patients are most often defined as age >65 years or age >69 years but also sometimes for a more narrowly defined subset of elderly patients such as age >79 years. For example, for elderly patients age >65 years the risk of mortality level is increased from minor to moderate for secondary diagnoses such as atrial fibrillation, chronic obstructive lung disease and nephritis, and is increased from moderate to major for acidosis and hypotension. For elderly
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  • Fall '18
  • Diagnosis-related group, DRGs

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