Ness level and the precerebral occlusion is a

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ness level, and the precerebral occlusion is a moderate severity of illness level, the cerebral embolism with infarct will be preserved and the severity of illness level of the precerebral occlu- sion will be reduced to one when they are both present as secondary diagnoses.
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36 8. Combine all secondary diagnoses to determine the base severity of illness subclass of the patient Once secondary diagnoses that are related to other secondary diagnoses have had their severity levels reduced to minor, the base patient severity of illness subclass is set equal to the maximum severity of illness level across all of the remaining secondary diagnoses. For example, if there are five remaining secondary diagnoses and one is a major severity of illness level and four are a moderate severity of illness level then the base patient subclass is major. 9. Reduce the base severity of illness subclass of patients with a major or extreme subclass unless the patient has multiple secondary diagnoses at a high severity level In order to be assigned to the major or extreme severity of illness subclass, a patient must have multiple secondary diagnoses at a high severity of illness level. High severity of illness patients are usually characterized by the presence of multiple high severity of illness secondary diag- noses. Patients with a base severity of illness subclass of extreme must have two or more secondary diagnoses that are an extreme severity of illness level, or one secondary diagnoses at an extreme severity of illness level plus at least two other secondary diagnoses at a major sever- ity of illness level—otherwise the base severity of illness subclass is reduced to major. Patients with a base severity of illness subclass of major must have two or more secondary diagnoses that are a major severity of illness level, or one secondary diagnosis at a major severity of illness level plus at least two other secondary diagnoses at a moderate severity of illness level—otherwise the base severity of illness subclass is reduced to moderate. Thus, a secondary diagnosis of AMI is not sufficient to assign a patient to an extreme severity of illness subclass. In addition to the AMI, there must be at least one additional extreme severity of illness secondary diagnosis (e.g., acute renal failure) or two or more additional major severity of illness secondary diagnoses (e.g., con- gestive heart failure and diabetic ketoacidosis). Phase III—Determine the final severity of illness subclass of the patient Once the base patient severity of illness subclass is computed, the patient severity of illness sub- class may be increased or decreased based on specific values of the following patient attributes: Combinations of APR-DRG and principal diagnosis Combinations of APR-DRG and age, or APR-DRG and principal diagnosis and age Combinations of APR-DRG and non-OR procedures Combinations of APR-DRG and OR procedures Combinations of APR-DRG and pairs of OR procedures
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  • Fall '18
  • Diagnosis-related group, DRGs

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