HSFTW
IntroductionToDRGs.pdf

Sometimes it is necessary to use a different foreign

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Sometimes it is necessary to use a different (foreign) version of ICD codes that the Grouper engine does not recognise. Also, the version of the Grouper may be upgraded and Hospitals may want to pass old data into the new Grouper version for benchmarking their historical data or for other reasons. Alternatively, a Health Insurer may not adopt the new Grouper version and/or new ICD coding version and the Hospital has to convert the patient coding to the outdated system, so they can be paid by the Insurer. An explanation of Australian mapping considerations follows. Germany has similar but different considerations. Recently, Australia switched from the old ICD9 to the new ICD10. Australia modifies this international classification to suit clinical circumstance in Australia. The letters "AM" mean "Australian Modified" and the letters "CM" mean "Clinically Modified".
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An Introduction to DRG's TC Health Administration © 19 The NCCH is the central Australian coding organisation that creates mapping tables for Australia. They are the resource center for Medical Record Administrators. These professionals are employed in each Hospital after a three year degree program. They are supported by "Coders' who are trained by correspondence and practical experience. Mappings between ICD-9-CM and ICD-10-AM disease and procedure codes were needed to facilitate a smooth transition between these two classifications. There are two types of mapping that can be performed: 1. Forward mapping; and 2. Backward mapping. Forward Mapping Is where a code from a previous year's data set is mapped to a new code in a subsequent year's data set because the previous code is now invalid. Forward mappings are used to group old data using new Grouper software and to compare incidences and prevalence of conditions and procedures over time. The NCCH has "Mapped" to compare those areas where ICD-9-CM is more specific than ICD- 10-AM and this mapping is built into the V4.0 Grouper. Backward Mapping Is where a "new" code from the current year's data set is mapped to a code from a previous year's data set in order to use a previous version of the Grouper, or to undertake time series data analysis. All ICD-10-AM codes have been mapped to the "equivalent" ICD-9-CM codes to enable grouping of ICD-10-AM codes in Groupers developed in ICD-9-CM codes.
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  • Fall '18
  • Diagnosis-related group, DRG

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