13 modify the risk of mortality subclass for the

Info icon This preview shows pages 58–60. Sign up to view the full content.

class of major if mechanical ventilation <96 hours is performed. 13. Modify the risk of mortality subclass for the patient based on combinations of APR-DRG and OR procedure Within specific APR-DRGs, some OR procedures are indicative of higher risk of mortality relative to the other OR procedures in the APR-DRG. For example, the risk of mortality subclass of patients in APR-DRG 443 Kidney and Urinary Tract Procedures for Non-Malignancy, is increased by two up to a maximum of major if the procedure bilateral nephrectomy is performed. Relative to other procedures in DRG 443, a bilateral nephrectomy represents a patient that has a higher risk of mortality. Within specific APR-DRGs, there are also some OR procedures that are indicative of lower risk of mortality relative to other patients in the same APR-DRG. For example, a patient in APR-DRG 220 Major Stomach Esophageal & Duodenal Procedures who receives a procedure to create eso- phogastric sphincteric competence has a lower risk of mortality than other surgical patients in
Image of page 58

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

53 APR-DRG 220 (e.g., esophagectomy, gastrectomy), and if up to this point in the process their risk of mortality subclass is moderate, it is decreased by 1 to minor. 14. Modify the risk of mortality subclass for the patient based on combinations of APR-DRG and pairs of OR procedures Within specific APR-DRGs the presence of certain pairs of OR procedures is indicative of a more extensive disease process and a higher risk of mortality relative to other patients in the same APR-DRG. For risk of mortality, this logic is applicable primarily for patients who receive both a peripheral bypass procedure and a lower limb amputation. For example, a patient in either APR-DRG 173 Other Vascular Procedures or APR-DRG 305 Amputation of Lower Limb who receives both a peripheral bypass procedure and a lower leg amputation has their risk of mortality subclass increased by an increment of one up to a maximum subclass of major. 15. Modify the risk of mortality subclass for the patient based upon combination of the APR-DRG for ECMO and presence/absence of certain OR procedures This step is not applicable to risk of mortality. 16. Modify the patient risk of mortality subclass based on the APR-DRG and principal diagnosis and certain non-OR procedures This step is not applicable to risk of mortality. 17. Establish a minimum risk of mortality subclass for the patient based on combinations of categories of secondary diagnoses The presence of certain combinations of secondary diagnoses has great clinical significance. The interaction of specific combinations of secondary diagnoses increases the risk of mortality. There- fore, a minimum patient risk of mortality subclass greater than subclass minor is established if certain combinations of secondary diagnoses are present. The presence of multiple interacting diagnoses is characteristic of high risk of mortality patients. A subset of secondary diagnoses will interact with each other causing patient risk of mortality to be increased.
Image of page 59
Image of page 60
This is the end of the preview. Sign up to access the rest of the document.
  • Fall '18
  • Diagnosis-related group, DRGs

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern