The risk of mortality level is decreased from extreme

Info icon This preview shows pages 54–56. Sign up to view the full content.

cedures, since the hydrocephalus is the underlying reason for performing the procedure. The risk of mortality level is decreased from extreme to major for secondary diagnosis of cerebral edema in a number of nervous system APR-DRGs including craniotomy, cerebrovascular disease, and malignancy. If there is essentially complete overlap between the secondary diagnosis and the APR-DRG, the risk of mortality level for the secondary diagnosis may be decreased from extreme or major to minor. For example, acute respiratory failure is decreased from extreme to minor for APR-DRGs for respiratory system diagnosis with mechanical ventilation 96+ hours and tracheo- stomy with mechanical ventilation 96+ hours. There are many secondary diagnoses for which the
Image of page 54

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

49 standard risk of mortality level is lowered to minor for a patient in one of eleven elective, non-extensive surgical APR-DRGs. For example, in these APR-DRGs, secondary diagnoses of malignant neoplasm are reduced from major or moderate to minor, since the patient would likely not have these surgical procedures performed if the malignancy was at a stage that represented a significant risk of mortality. 6. Modify the standard risk of mortality level of a secondary diagnosis based on non-OR procedure Certain non-OR procedures will sometimes be used to modify the standard risk of mortality level of some secondary diagnoses. For risk of mortality, this step is just used with one non-OR proce- dure, pulsation balloon implant. For example, subendocardial infarction has a standard risk of mortality level of moderate but is increased by an increment of two up to extreme if the patient had a pulsation balloon implanted. The need for the pulsation balloon is an indicator of the extent of the subendocardial infarction. Phase II—Determine the base risk of mortality subclass for the patient Once each secondary diagnosis has been assigned its standard risk of mortality level and the standard risk of mortality level of each secondary diagnosis has been modified based on the patient’s age, APR-DRG and principal diagnosis, APR-DRG, and certain non-OR procedure, the Phase II base risk of mortality subclass for the patient can be determined. The process of deter- mining the base patient risk of mortality subclass begins with the elimination of certain secondary diagnoses that are closely related to other secondary diagnoses. The elimination of these diag- noses prevents the double counting of clinically similar diagnoses in the determination of the risk of mortality subclass of the patient. Once redundant diagnoses have been eliminated, the base risk of mortality subclass is determined based on all of the remaining secondary diagnoses. There are three steps to Phase II for risk of mortality. The first two are the same as for severity of illness. The third step is similar to severity of illness but has some additional exceptions logic.
Image of page 55
Image of page 56
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