Table 11 major diagnostic categories 1 diseases and

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Table 1–1. Major Diagnostic Categories 1 Diseases and Disorders of the Nervous System 2 Diseases and Disorders of the Eye 3 Ear, Nose, Mouth, Throat, and Craniofacial Diseases and Disorders 4 Diseases and Disorders of the Respiratory System 5 Diseases and Disorders of the Circulatory System 6 Diseases and Disorders of the Digestive System 7 Diseases and Disorders of the Hepatobiliary System and Pancreas 8 Diseases and Disorders of the Musculoskeletal System and Connective Tissue 9 Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast 10 Endocrine, Nutritional and Metabolic Diseases and Disorders 11 Diseases and Disorders of the Kidney and Urinary Tract 12 Diseases and Disorders of the Male Reproductive System 13 Diseases and Disorders of the Female Reproductive System 14 Pregnancy, Childbirth and the Puerperium 15 Newborns and Other Neonates with Conditions Originating in the Perinatal Period 16 Diseases and Disorders of Blood, Blood Forming Organs and Immunological Disorders 17 Lymphatic, Hematopoietic, Other Malignancies, Chemotherapy and Radiotherapy 18 Infectious and Parasitic Diseases, Systemic or Unspecified Sites 19 Mental Diseases and Disorders 20 Alcohol/Drug Use and Alcohol/Drug Induced Organic Mental Disorders 21 Poisonings, Toxic Effects, Other Injuries and Other Complications of Treatment 22 Burns
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15 Major complications and comorbidities Some complications and comorbidities (CC) will have a greater impact on hospital resource use than other CCs. For example, a secondary diagnosis of septicemia will in general be more resource intensive than a CC of chronic ulcer. The AP-DRGs designate a subset of the CCs as major CCs. The impact of the presence of a major CC was evaluated for each MDC. In many MDCs, the pres- ence of a major CC tended to have a dominate effect on the resources used by the patient. In recognition of the impact of major CCs and in order to avoid significantly increasing the number of DRGs, a single major CC AP-DRG across all surgical patients within an MDC and a single major CC AP-DRG across all medical patients within an MDC were formed for some MDCs. It was not always possible to form a single major CC AP-DRG for the medical or surgical portion of an MDC. For example, in MDC 1, it was necessary to form two major CC AP-DRGs for surgical patients consisting of patients with a craniotomy versus patients with any other nervous system procedure. At least two major CC AP-DRGs were created for each MDC with the exception of MDCs 14, 15, 19, 20 and 22–24 in which no major CC AP-DRGs were created. In total, there are 60 major CC AP-DRGs. AP-DRG hierarchy The departure in the AP-DRGs from the use of principal diagnosis as the initial variable in DRG assignment made it necessary to form a hierarchy of all the exceptions to the principal diagnosis based assignment to an MDC. The hierarchy for assigning patients to an AP-DRG is shown in table 1–2. For example, based on this hierarchy, if a patient has a tracheostomy and multiple trauma, the patient is assigned to the appropriate tracheostomy AP-DRG.
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  • Fall '18
  • Diagnosis-related group, DRGs

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