Improve the clinical distinction between related apr

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APR-DRG 202 Angina Pectoris and APR-DRG 198 Coronary Atherosclerosis. Improve the clinical distinction between related APR-DRGs; e.g., redefine APR-DRGs 301 and 302 for joint replacement to be based on the joint replaced (i.e., hip versus knee) instead of the etiology (i.e., trauma versus non trauma). For MDC 22 (Burns), re-conceptualize the APR-DRGs to give further emphasis to third degree burns. For MDC 24 (Human Immunodeficiency Virus Infections), refine the list of major HIV related conditions and significant HIV related conditions. For MDC 25 (Multiple Significant Trauma), redefine the APR-DRGs giving more emphasis to the surgical categories. Throughout the MDCs, consistently define APR-DRGs for which the reason for the hospital- ization is a complication of treatment. These APR-DRGs now exist in MDCs 5, 6, 8, 11, 18, and 21. Throughout the MDCs, refine and make more consistent the definition of Other Related OR Procedures APR-DRGs. Substantially redefine the three APR-DRGs for OR Procedures Unrelated to Principal Diagno- sis so that each is defined by a distinct level of surgical complexity. Reclassification of OR Procedures The APR-DRG system has reevaluated the procedure codes considered OR procedures which in turn affects whether a patient will be assigned to a surgical or medical APR-DRG. Version 20.0 APR-DRGs removed 62 procedure codes from the APR-DRG list of OR procedures, leading to two-and-a-half percent fewer patients classified into surgical APR-DRGs. The highest impact reclassified procedure is excisional debridement. Next most common is endoscopic lung biopsy followed by certain other biopsies of bone, soft tissue, blood vessel, cervix, uterus, and bladder. Other reclassified procedures with volume are interruption of vena cava and linear repair eyelid laceration. The APR-DRGs most affected by these procedure code reclassifications are the APR-DRGs previously defined on the basis of skin graft or excisional wound debridement in MDCs 8, 9, 10, and 21 and the “other OR procedure” APR-DRGs throughout the various MDCs. Revise MDC definitions The APR-DRG system has introduced numerous changes to MDC definitions, especially with Ver- sion 20.0 APR-DRGs. The age definition for MDC 15 (Newborns & Other Neonates with Conditions Originating in the Perinatal Period) was narrowed as described previously. MDC 25 (Multiple Significant Trauma) was updated with respect to the lists of significant trauma diagnoses and the introduction of OR procedures to clarify whether certain diagnoses represent significant trauma. The net effect was to decrease the number of MDC 25 medical patients and increase the number of MDC 25 surgical patients. MDC 24 (Human Immunodeficiency Virus Infections) was updated with respect to the defini- tion of HIV related diagnoses, leading to somewhat fewer patients assigned to MDC 24.
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  • Fall '18
  • Diagnosis-related group, DRGs

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