A type 5 combination consists of two categories that

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A type 5 combination consists of two categories that contain minor risk of mortality level diag- noses, plus any two additional secondary diagnoses that are at least a minor risk of mortality level. For a type 5 combination, the minimum patient risk of mortality is moderate. An example of a type 5 combination is atrial fibrillation (category 8) and hypovolemia (category 51) combined with any other two minor secondary diagnoses. A type 13 combination consists of two secondary diagnosis categories that contain moderate risk of mortality diagnoses, plus any third secondary diagnosis that is at least a moderate risk of mor- tality diagnosis. For a type 13 combination, the minimum patient risk of mortality subclass is major. An example of a type 13 combination is cirrhosis (category 23) and hypotension (category 50) combined with any other moderate secondary diagnosis. 18. Compute the final risk of mortality subclass The final patient risk of mortality subclass is computed based on the Phase II base patient risk of mortality subclass and the Phase III modified patient risk of mortality subclasses. If all the Phase III modified risk of mortality are greater than or equal to the Phase II base risk of mortality sub- class, then the final risk of mortality subclass is computed as the maximum of the Phase II and III risk of mortality subclasses. If all of the modified Phase III risk of mortality subclasses are less than or equal to the Phase II base risk of mortality subclass, the final risk of mortality subclass is computed as the Phase II base risk of mortality subclass minus one. If the Phase II modified risk of mortality subclasses includes modified risk of mortality subclasses that are both greater and less than the Phase II base risk of mortality subclass, the modified Phase III subclass relating to procedures and combinations of secondary diagnoses will take priority in determining the final risk of mortality subclass. The combination of the APR-DRG and the final patient risk of mortality sub- class constitute the complete APR-DRG description of the risk of mortality of the patient. Summary of APR-DRG risk of mortality subclass assignment logic The following is a summary of the steps involved in computing the APR-DRG risk of mortality sub- class of a patient. Phase I—Determine the risk of mortality level of each secondary diagnosis 1. Eliminate all secondary diagnoses that are associated with the principal diagnosis of the patient.
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55 2. Assign each secondary diagnosis its standard risk of mortality. 3. Modify the standard risk of mortality level of each secondary diagnosis based on the age of the patient. 4. Modify the standard risk of mortality level of each secondary diagnosis based on the APR-DRG and principal diagnosis (applicable only to APR-DRG 190 Acute Myocardial Infarct).
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  • Fall '18
  • Diagnosis-related group, DRGs

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