- DRG Codes Assigned to Hospital Acquired Conditions
- Diagnosis Group Assigned to Hospital Acquired Conditions
- DRG Codes
- Diagnosis Related Groups
- CMS DRG
- Diagnosis Group
- Hospital Acquired Conditions
Diagnosis Related Groups Assigned to Hospital Acquired Conditions
The following dataset consists of Hospital-Acquired Conditions (HACs) which are conditions that occur after the physician writes the inpatient admission order and that could have been reasonably prevented through the application of evidence-based guidelines and best practices.
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A Diagnosis-Related Group (DRG) is a statistical system of classifying any inpatient stay into groups for the purposes of payment. The DRG classification system divides possible diagnoses into 25 major body systems and subdivides them into one of 747 groups for the purpose of Medicare reimbursement. DRG grouper system has been used by Medicare since 1983 to reimburse hospitals for inpatient admissions. Factors used to determine the DRG payment amount include the diagnosis involved as well as the hospital resources necessary to treat the condition. Also used by a few states for all payors and by many private health plans (usually non-HMO) for contracting purpose. Hospitals are paid a fixed rate for inpatient services corresponding to the DRG group assigned to a given patient.
In 2007, CMS began monitoring claims for hospital-acquired conditions (HAC). Today, Medicare denies approximately $20 million per year under the HAC policy.
Additionally, four HACs comprise 12.2% of total medical professional liability costs:
– Hospital-acquired infections
– Hospital-acquired injuries
– Objects left in surgery
– Pressure ulcers
CMS focuses on these HACs due to the abundance of data that supports the assertion that these are preventable conditions. Reporting and capturing HACs allow hospital administrators and CMS to measure the facility’s performance, distinguish between pre-existing conditions and those acquired in the hospital, and to increase the validity of hospital report cards related to quality.
About this Dataset
John Snow Labs; Centers for Medicare & Medicaid Services;
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DRG, DRG Codes, Diagnosis Related Groups, CMS DRG, Diagnosis Group, HAC, Hospital Acquired Conditions
DRG Codes Assigned to Hospital Acquired Conditions, Diagnosis Group Assigned to Hospital Acquired Conditions
|Hospital_Acquired_Condition_Code||Codes assigned to hospital-acquired conditions ( HAC 01 - HAC 14)||string||-|
|Description_of_Hospital_Acquired_Condition_Code||Description of HAC Code||string||-|
|Procedure_Code||Procedure code from ICD-10-PCS code list, that accurately represents the procedure performed.||string||-|
|Procedure_Description||Description of the procedure code||string||-|
|Primary_Diagnosis_Code||ICD-10 Diagnosis Code pertaining to Primary Diagnosis||string||-|
|Primary_Diagnosis_Description||Description of ICD-10 Diagnosis Code for Primary Diagnosis||string||-|
|Secondary_Diagnosis||ICD-10 Diagnosis Code pertaining to Secondary Diagnosis||string||-|
|Secondary_Diagnosis_Level||Refers to either a complication or comorbidity (CC) or a major complication or comorbidity (MCC) when used as a secondary diagnosis.||string||-|
|Secondary_Diagnosis_Description||Description of ICD-10 Diagnosis Code for Secondary Diagnosis||string||-|
|Hospital Acquired Condition Code||Description of Hospital Acquired Condition Code||Procedure Code||Procedure Description||Primary Diagnosis Code||Primary Diagnosis Description||Secondary Diagnosis||Secondary Diagnosis Level||Secondary Diagnosis Description|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81500A||CC||Unspecified complication of foreign body accidentally left in body following surgical operation, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81501A||CC||Unspecified complication of foreign body accidentally left in body following infusion or transfusion, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81502A||CC||Unspecified complication of foreign body accidentally left in body following kidney dialysis, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81503A||CC||Unspecified complication of foreign body accidentally left in body following injection or immunization, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81504A||CC||Unspecified complication of foreign body accidentally left in body following endoscopic examination, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81505A||CC||Unspecified complication of foreign body accidentally left in body following heart catheterization, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81506A||CC||Unspecified complication of foreign body accidentally left in body following aspiration, puncture or other catheterization, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81507A||CC||Unspecified complication of foreign body accidentally left in body following removal of catheter or packing, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81508A||CC||Unspecified complication of foreign body accidentally left in body following other procedure, initial encounter|
|HAC 01||FOREIGN OBJECT RETAINED AFTER SURGERY||T81509A||CC||Unspecified complication of foreign body accidentally left in body following unspecified procedure, initial encounter|