Hospital Industry Data Institute ICD-10 Transitional Strategy

Hospital Industry Data Institute ICD-10 Transitional Strategy

© Hospital Industry Data Institute 1 Revised July 2016

DELAY IN ICD-10 SOFTWARE READINESS AFFECTING SELECT INDICATORS: ISSUES IDENTIFIED AND PRODUCT IMPACT

ISSUES IDENTIFIED

Q: What ICD-10 transition and readiness issues are being considered? A: Hospitals transitioned to using ICD-10 diagnosis and procedure codes for all administrative

claims effective Oct. 1, 2015. The Agency for Healthcare Research and Quality and the Centers for Medicare & Medicaid Services have not yet released ICD-10 compliant versions of software programs used to produce risk-adjusted measures of quality, safety and readmissions used in a number of reports produced by HIDI.

Q: What HIDI reports and deliverables are impacted? A: All internal and external HIDI reporting and analytic deliverables involving risk-adjusted AHRQ

indicators and 30-day readmissions for discharges dated Oct. 1, 2015, forward, including reports available on HIDI Analytic Advantage® and HIDI Analytic Advantage® PLUS, as well as transparency initiative reporting displayed on the Focus on Hospitals website.

Q: How will the delayed availability of ICD-10 ready software impact these products? A: In the absence of action, risk-adjusted reporting of impacted reports and deliverables for ICD-

10 coded discharges would be suspended until ICD-10 ready software versions are made available by AHRQ and CMS.

PRODUCT IMPACT

Q: What is the plan for affected products? A: To provide continued support and delivery for affected measures, HIDI will use the GEM ICD-

10 to ICD-9 crosswalk provided by CMS to “backmap” ICD-10 coded discharges to comparable ICD-9 codes to the extent necessary to enable use of available software to produce risk-adjusted rates. For readmission measures, this means that selection criteria for condition-specific cohorts will be based on submitted ICD-10 codes that are then backmapped to ICD-9 codes. Condition codes used for risk-adjustment purposes will be based on all submitted ICD-10 codes backmapped to comparable ICD-9 codes. For AHRQ indicators, condition codes used to produce risk-adjusted calculations will be based on ICD-10 codes backmapped to comparable ICD-9 codes using the GEM crosswalk. AHRQ’s risk-adjusted calculations will continue to be based on expected rates calculated from 2012 nation data for the foreseeable future.



Q: What is the overall timeline for the strategy with impacted products to take effect? A: Programming and preparation to operationalize the strategy with impacted reporting is

complete, and scheduled to take effect with the April release of reports. HIDI plans to continue with this strategy until ICD-10 ready versions of affected programs are made available and fully evaluated.

Q: Are there specific things that report users need to consider once reporting with the transitions to ICD-10 coded data?

A: The transition to ICD-10 is a significant change that has numerous implications for measures and reporting based on administrative billing codes. Changes in measured performance corresponding with the Oct. 1, 2015, transition to ICD-10 should be evaluated carefully and interpreted with caution. The HIDI team has processes and plans in place to monitor measures through this transition with the aim of identifying systematic trends resulting from the transition. As always, we encourage report users to contact a HIDI representative if you have questions or concerns about measured performance.

CUSTOMER SUPPORT AND EDUCATION

Q: Will there be supporting client documentation for this ICD-10 readiness change? A: AHRQ and readmission detail methodology will be provided upon request.

Q: Will there be any special training for HIDI users around this to ICD-10 readiness? A: While no special training for HIDI users will be needed to support these changes, HIDI is

planning a small number of webinars to discuss strategies with ICD-10 affected reports and provide a forum for questions and feedback. As always, we encourage all our stakeholders to contact a HIDI representative by phone or email with questions or concerns.

Q: Will HIDI provide a mapping between ICD-9 and ICD-10? A: The GEM ICD-10 to ICD-9 crosswalk, as well as other information regarding GEM coding, can

be found on CMS’ website.

Q: With the transition to ICD-10, how will HIDI reporting support trending analyses? A: The transition to ICD-10 is a significant change with numerous implications for measures and

reporting based on administrative billing codes. Changes in measured performance corresponding with the Oct. 1, 2015 transition to ICD-10 should be evaluated carefully and interpreted with caution. The HIDI team has processes and plans in place to monitor measures through this transition with the aim of identifying systematic trends resulting from the transition. As always, we encourage report users to contact a HIDI representative if you have questions or concerns about measured performance.

Q: Who should I contact with questions? A: Contact a HIDI representative.



TECHNICAL MANUAL

ICD-10 TRANSITIONAL ACTIVITIES FOR READMISSION REPORTING

Hospitals transitioned to using ICD-10 diagnosis and procedure codes for all administrative claims effective Oct. 1, 2015. The Centers for Medicare & Medicaid Services has not yet released ICD-10 compliant versions of the software program used to produce risk-adjusted readmissions measures. However, CMS did provide a list of ICD-10 codes that they expect to be representative of the readmissions measures going forward. HIDI extracted records including appropriate ICD-10 codes, back-mapped those records using GEM coding to display ICD-9 codes, and used the ICD-9 compliant model to produce readmissions reports. HIDI plans to continue with this strategy until ICD-10 ready versions of affected programs are made available and fully evaluated. The transition to ICD-10 is a significant change that has numerous implications for measures and reporting based on administrative billing codes. Changes in measured performance corresponding with the Oct. 1, 2015, transition to ICD-10 should be evaluated carefully and interpreted with caution. The HIDI team has processes and plans in place to monitor measures through this transition with the aim of identifying systematic trends resulting from the transition.

GENERAL INFORMATION

HIDI readmissions reports present hospital-specific readmission measures for acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, stroke, hip/knee and pneumonia patients ages 18 and older residing in the state, with any payer. Hospital-wide readmissions also are included. Risk-adjusted metrics are considered unreliable for providers with fewer than 25 total readmissions during the 36-month period. The measures are developed by applying the methods used by the Centers for Medicare & Medicaid Services for public reporting and determining reimbursement penalties under the Hospital Readmission Reduction Program to the most recently-available 36 months of hospital discharge data.

Data Steward: HIDI Custom Measure and the Centers for Medicare & Medicaid Services.

Data Source: Discharge claims data Exclusions: Patient deaths, transfer patients, admissions with zero days to subsequent hospitalization, patients who leave against medical advice, obstetric and non-acute patients are excluded from the model cohorts, as are readmissions flagged by the CMS/Yale Planned Readmission Algorithm. Patient deaths are identified by discharge disposition codes of 20-Expired, 40-Expired at Home, 41-Expired in a Medical Facility, and 42-Expired in an Unknown Place. Transfer patients are identified by discharge disposition code 2-Short-Term General Hospital for Inpatient Care. Transfer



patient records are removed from the transferring facility and assigned to the final receiving facility. Zero-day patients are identified if the admission date is equal to the previous discharge date. Self-discharges AMA are identified by discharge disposition code 7-Left against medical advice or discontinued care. Non-acute patients are defined by inpatient place of services codes: 2-Psychiatric Unit, 3-Medical Rehabilitation Unit, 4-Alternate Level of Care, 5-Alcohol Rehabilitation Unit or 6-Drug Rehabilitation Unit. MDC 19 and MDC 20 also are omitted for psychiatric disorders and substance abuse. Obstetric patients are identified with MDC 14 — pregnancy, childbirth and puerperium.

Risk Adjustment: CMS/Yale Model — Hierarchical generalized logistic regression adjusted for age group, sex and medical condition. For each hospital, the models produce a predicted readmission rate, an expected readmission rate, a risk-standardized readmission ratio and a risk-standardized readmission rate. The predicted rate controls for patient-level risk. The expected rate controls for provider-level risk. The SRR is the ratio of predicted-to-expected readmission rates for each hospital. The SRR is similar to an observed-to-expected ratio where a value below one indicates lower than expected readmissions and a value above one indicates higher than expected readmissions. The hospital RSRRs are standardized by multiplying the SRR for each hospital by the observed readmission rate for the entire state. Hospital-specific estimates are shown along with estimates for all hospitals in the state.

Observed Rate = Number of Readmissions/Number of Index Admissions RSR Ratio = Predicted /Expected Readmission RSR Rate = RSR Ratio *Statewide Observed Rate RSR Ranking = Providers with 25 or more index admissions are ranked according to the number

of readmissions for each condition, with #1 indicating the lowest number of readmissions.



ACUTE MYOCARDIAL INFARCTION

Measure Name: AMI

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The AMI measure includes index admissions for qualifying diagnoses and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a primary diagnosis of AMI, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a primary diagnosis of AMI, and who do not meet any exclusion criteria listed below. Index admissions for AMI were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.

ICD-9-CM DIAGNOSIS CODE DESCRIPTION

Any 410.xx excluding 410.x2 ACUTE MYOCARDIAL INFARCTION


I2101 STEMI INVOLVING LEFT MAIN CORONARY ARTERY

I2102 STEMI INVOLVING LEFT ANTERIOR DESCENDING CORONARY ARTERY

I2109 STEMI INVOLVING OTH CORONARY ARTERY OF ANTERIOR WALL

I2111 STEMI INVOLVING RIGHT CORONARY ARTERY

I2119 STEMI INVOLVING OTH CORONARY ARTERY OF INFERIOR WALL

I2121 STEMI INVOLVING LEFT CIRCUMFLEX CORONARY ARTERY

I2129 STEMI INVOLVING OTHER SITES

I213 ST ELEVATION (STEMI) MYOCARDIAL INFARCTION OF UNSP SITE

I214 NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION

I220 SUBSEQUENT STEMI OF ANTERIOR WALL

I221 SUBSEQUENT STEMI OF INFERIOR WALL

I222 SUBSEQUENT NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION

I228 SUBSEQUENT STEMI OF SITES

I229 SUBSEQUENT STEMI OF UNSP SITE



CONGESTIVE HEART FAILURE

Measure Name: HF

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The congestive heart failure measure includes index admissions for qualifying diagnoses and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a primary diagnosis of CHF, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a primary diagnosis of CHF, and who do not meet any exclusion criteria. Index admissions for CHF were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.


40201 MAL HYPERT HRT DIS W HF

40211 BENIGN HYP HT DIS W HF

40291 HYP HT DIS NOS W HT FAIL

40401 MAL HYP HT/KD I-IV W HF

40403 MAL HYP HT/KD STG V W HF

40411 BEN HYP HT/KD I-IV W HF

40413 BEN HYP HT/KD STG V W HF

40491 HYP HT/KD NOS I-IV W HF

40493 HYP HT/KD NOS ST V W HF

428.xx CONGESTIVE HEART FAILURE


I110 HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

I130 HYP HRT & CHR KDNY DIS W HRT FAILAND STG 1-4/UNSP CHR KDNY

I132 HYP HRT & CHR KDNY DIS W HRT FAILAND W STG 5 CHR KDNY/ESRD

I501 LEFT VENTRICULAR FAILURE

I5020 UNSPECIFIED SYSTOLIC (CONGESTIVE) HEART FAILURE

I5201 ACUTE SYSTOLIC (CONGESTIVE) HEART FAILURE




I5022 CHRONIC SYSTOLIC (CONGESTIVE) HEART FAILURE

I5023 ACUTE ON CHRONIC SYSTOLIC (CONGESTIVE) HEART FAILURE

I5030 UNSPECIFIED DIASTOLIC (CONGESTIVE) HEART FAILURE

I5031 ACUTE DIASTOLIC (CONGESTIVE) HEART FAILURE

I5032 CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE

I5033 ACUTE ON CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE

I5040 UNSP COMBINED SYSTOLIC AND DIASTOLIC (CONGESTIVE) HRT FAIL

I5041 ACUTE COMBINED SYSTOLIC AND DIASTOLIC (CONGESTIVE) HRT FAIL

I5042 CHRONIC COMBINED SYSTOLIC AND DIASTOLIC HRT FAIL

I5043 ACUTE ON CHRONIC COMBINED SYSTOLIC AND DIASTOLIC HRT FAIL

I509 HEART FAILURE, UNSPECIFIED



PNEUMONIA

Measure Name: PN

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The pneumonia measure includes index admissions for qualifying diagnoses and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a primary diagnosis of pneumonia, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a primary diagnosis of pneumonia, and who do not meet any exclusion criteria. Index admissions for pneumonia were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.


4800 ADENOVIRAL PNEUMONIA

4801 RESP SYNCYT VIRAL PNEUM

4802 PARINFLUENZA VIRAL PNEUM

4803 PNEUMONIA DUE TO SARS

4808 VIRAL PNEUMONIA NEC

4809 VIRAL PNEUMONIA NOS

481 PNEUMOCOCCAL PNEUMONIA

4820 K. PNEUMONIAE PNEUMONIA

4821 PSEUDOMONAL PNEUMONIA

4822 H.INFLUENZAE PNEUMONIA

48230 STREPTOCOCCAL PNEUMN NOS

48231 PNEUMONIA STRPTOCOCCUS A

48232 PNEUMONIA STRPTOCOCCUS B

48239 PNEUMONIA OTH STREP

48240 STAPHYLOCOCCAL PNEU NOS

48241 METH SUS PNEUM D/T STAPH

48242 METH RES PNEU D/T STAPH

4870 INFLUENZA WITH PNEUMONIA

48811 FLU DT 2009 H1N1 W PNEU




48249 STAPH PNEUMONIA NEC

48281 PNEUMONIA ANAEROBES

48282 PNEUMONIA E COLI

48283 PNEUMO OTH GRM-NEG BACT

48284 LEGIONNAIRES’ DISEASE

48289 PNEUMONIA OTH SPCF BACT

4829 BACTERIAL PNEUMONIA NOS

4830 PNEU MYCPLSM PNEUMONIAE

4831 PNEUMONIA D/T CHLAMYDIA

4838 PNEUMON OTH SPEC ORGNSM

485 BRONCHOPNEUMONIA ORG NOS

486 PNEUMONIA, ORGANISM UNSPECIFIED CONVERT


A481 LEGIONNAIRES’ DISEASE

J1100 FLU DUE TO UNIDENTIFIED FLU VIRUS W UNSP TYPE OF PNEUMONIA

J120 ADENOVIRAL PNEUMONIA

J121 RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA

J122 PARAINFLUENZA VIRUS PNEUMONIA

J1281 PNEUMONIA DUE TO SARS-ASSOCIATED CORONAVIRUS

J1289 OTHER VIRAL PNEUMONIA

J129 VIRAL PNEUMONIA UNSPECIFIED

J13 PNEUMONIA DUE TO STREPTOCOCCUS PNEUMONIAE

J14 PNEUMONIA DUE TO HEMOPHILUS INFLUENZAE

J150 PNEUMONIA DUE TO KLEBSIELLA PNEUMONIAE

J151 PNEUMONIA DUE TO PSEUDOMOMAS

J1520 PNEUMONIA DUE TO STAPHYLOCOCCUS, UNSPECIFIED

J15211 PNEUMONIA DUE TO METHICILLIAN SUSCEP STAPH

J15212 PNEUMONIA DUE TO METHICILLIN RESISTANT STAPHYLOCOCUS AUREUS

J1529 PNEUMONIA DUE TO OTHER STAPHYLOCOCCUS

J153 PNEUMONIA DUE TO STREPTOCOCCUS, GROUP B

J154 PNEUMONIA DUE TO OTHER STREPTOCOCCI

J155 PNEUMONIA DUE TO ESCHERICHIA COLI




J156 PNEUMONIA DUE TO OTHER AEROBIC GRAM-NEGATIVE BACTERIA

J157 PNEUMONIA DUE TO MYCOPLASMA PNEUMONIAE

J158 PNEUMONIA DUE TO OTHER SPECIFIED BACTERIA

J159 UNSPECFIFIED BACTERIAL PNEUMONIA

J160 CHYLAMIDIA PNEUMONIA

J168 PNEUMONIA DUE TO OTHER SPECIFIED INFECTIOUS ORGANISMS

J180 BRONCHOPNEUMONIA, UNSPECIFIED ORGANSIM

J181 LOBAR PNEUMONIA, UNSPECIFIED ORGANISM

J189 PNEUMONIA, UNSPECIFIED ORGANISM



CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Measure Name: COPD

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The COPD measure includes index admissions for qualifying diagnoses and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a primary diagnosis of COPD, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a primary diagnosis of COPD, and who do not meet any exclusion criteria. Index admissions for COPD were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.


49121 OBS CHR BRONC W(AC) EXAC

49122 OBS CHR BRONC W AC BRONC

4918 CHRONIC BRONCHITIS NEC

4919 CHRONIC BRONCHITIS NOS

4928 EMPHYSEMA NEC

49320 CHRONIC OBST ASTHMA NOS

49321 CH OB ASTHMA W STAT ASTH

49322 CH OBST ASTH W (AC) EXAC

496 CHRONIC AIRWAY OBSTRUCTION, NOT ELSEWHERE CLASSIFIED

51881 (with 49121, 49122, 49321 or 49322)

ACUTE RESPIRATRY FAILURE

51882 (with 49121, 49122, 49321 or 49322)

OTHER PULMONARY INSUFF

58144 (with 49121, 49122, 49321 or 49322)

ACUTE AND CHRONIC RESP FAILURE

7991 (with 49121, 49122, 49321 or 49322)

RESPIRATORY ARREST




J418 MIXED SIMPLE AND MUCOPURULENT CHRONIC BRONCHITIS

J42 UNSPECIFIED CHRONIC BRONCHITIS

J439 EMPHYSEMA, UNSPECIFIED

J440 CHRONIC OBSTRUCTIVE PULMON DISEASE W ACUTE LOWER RESP INFCT

J441 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W (ACUTE) EXACERBATION

J449 CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED

J80 ACUTE RESPIRATORY DISTRESS SYNDROME

J9600 ACUTE RESPIRATORY FAILURE, UNSP W HYPOXIA OR HYPERCAPNIA

J9620 ACUTE AND CHR RESP FAILURE, UNSP W HYPOXIA OR HYPERCAPNIA

J9690 RESPIRATORY FAILURE, UNSP, UNSP W HYPOXIA OR HYPERCAPNIA

R092 RESPIRATORY ARREST



STROKE

Measure Name: STROKE

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The ischemic stroke measure includes index admissions for qualifying diagnoses and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a diagnosis of ischemic stroke, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a diagnosis of ischemic stroke, and who do not meet any exclusion criteria. Index admissions for ischemic stroke were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.


43301 OCCLUSION AND STENOSIS OF BASILAR ARTERY WITH CEREBRAL INFRACTION

43311 OCCLUSION AND STENOSIS OF CAROTID ARTERY WITH CEREBRAL INFECTION

43321 OCCLUSION AND STENOSIS OF VERTEBRAL ARTERY WITH CEREBRAL INFARCTION

43331 OCCLUSION AND STENOSIS OF MULTIPLE AND BILATERAL PRECEREBRAL ARTERIES WITH CEREBRAL INFARCTION

43381 OCCLUSION AND STENOSIS OF OTHER SPECIFIED PRECEREBRAL ARTERY WITH CEREBRAL INFARCTION

43391 OCCLUSION AND STENOSIS OF UNSPECIFIED PRECEREBRAL ARTERY WITH CEREBRAL INFARCTION

43401 CEREBRAL THROMBOSIS WITH CEREBRAL INFARCTION

43411 CEREBRAL EMBOLISM WITH CEREBRAL INFARCTION

43491 CEREBRAL ARTERY OCCLUSION, UNSPECIFIED WITH CEREBRAL INFARCTION


I6300 CEREBRAL INFARCTION DUE TO THROMBOS UNSP PRECEREBRAL ARTERY

I63011 CEREBRAL INFARCTION DUE TO THROMBOSIS OF R VERTEB ART

I6302 CEREBRAL INFARCTION DUE TO THROMBOSIS OF L VERTEB ART

I63019 CEREBRAL INFARCTION DUE TO THROMBOS UNSP VERTEBRAL ARTERY




I6302 CEREBRAL INFARCTION DUE TO THROMBOSIS OF BASILAR ARTERY

I63031 CEREBRAL INFRC DUE TO THROMBOSIS OF RIGHT CAROTID ARTERY

I63032 CEREBRAL INFARCTION DUE TO THROMBOSIS OF LEFT CAROTID ARTERY

I63039 CEREBRAL INFARCTION DUE TO THROMBOSIS OF UNSP CAROTID ARTERY

I6309 CEREBRAL INFARCTION DUE TO THROMBOSIS OF PRECEREBRAL ARTERY

I6310 CEREBRAL INFARCTION DUE TO EMBOLISM OF UNSP PRECEREB ARTERY

I63111 CEREBRAL INFARCTION DUE TO EMBOLISM OF R VERTEB ART

I63112 CEREBRAL INFARCTION DUE TO EMBOLISM OF LEFT VERTEBRAL ARTERY

I63119 CEREBRAL INFARCTION DUE TO EMBOLISM OF UNSP VERTEBRAL ARTERY

I6312 CEREBRAL INFARCTION DUE TO EMBOLISM OF BASILAR ARTERY

I63131 CEREBRAL INFARCTION DUE TO EMBOLISM OF RIGHT CAROTID ARTERY

I63132 CEREBRAL INFARCTION DUE TO EMBOLISM OF LEFT CAROTID ARTERY

I63139 CEREBRAL INFARCTION DUE TO EMBOLISM OF UNSP CAROTID ARTERY

I6319 CEREBRAL INFARCTION DUE TO EMBOLISM OF PRECEREBRAL ARTERY

I6320 CERES INFRC DUE TO UNSP OCCLS OR STENOS OF UNSP PRECERB ART

I63211 CERES INFRC DUE TO UNSP OCCLS OR STENOS OF RIGHT VERTEB ART

I63212 CERES INFRC DUE TO UNSP OCCLS OR STENOSIS OF LEFT VERTEB ART

I63219 CERES INFRC DUE TO UNSP OCCLS OR STENOSIS OF UNSP VERTEB ART

I6322 CEREBRAL INFRC DUE TO UNSP OCCLS OR STENOSIS OF BASILAR ART

I63231 CERES INFRC DUE TO UNSP OCCLS OR STENOS OF RIGHT CAROTID ART

I63232 CERES INFRC DUE TO UNSP OCCLS OR STENOS OF LEFT CAROTID ART

I63239 CERES INFRC DUE TO UNSP OCCLS OR STENOS OF UNSP CAROTID ART

I6329 CEREBRAL INFRC DUE TO UNSP OCCLS OR STENOSIS OF PRECERB ART

I6330 CEREBRAL INFARCTION DUE TO THOMBOS UNSP CEREBRAL ARTERY

I63311 CERES INFRC DUE TO THOMBOS OF RIGHT MIDDLE CEREBRAL ARTERY

I63312 CEREBRAL INFRC DUE TO THOMBOS OF LEFT MIDDLE CEREBRAL ARTERY

I63319 CEREBRAL INFRC DUE TO THOMBOS UNSP MIDDLE CEREBRAL ARTERY

I63321 CEREBRAL INFRC DUE TO THOMBOS OF RIGHT ANT CEREBRAL ARTERY

I63322 CEREBRAL INFRC DUE TO THOMBOS OF LEFT ANT CEREBRAL ARTERY

I63329 CEREBRAL INFRC DUE TO THOMBOS UNSP ANTERIOR CEREBRAL ARTERY

I63331 CEREBRAL INFRC DUE TO THOMBOS OF RIGHT POST CEREBRAL ARTERY

I63332 CEREBRAL INFRC DUE TO THOMBOS OF LEFT POST CEREBRAL ARTERY

I63339 CEREBRAL INFRC DUE TO THOMBOS UNSP POSTERIOR CEREBRAL ARTERY

I63341 CEREBRAL INFRC DUE TO THROMBOSIS OF RIGHT CEREBLR ARTERY

I63342 CEREBRAL INFARCTION DUE TO THROMBOSIS OF LEFT CEREBLR ARTERY




I63349 CEREBRAL INFARCTION DUE TO THOMBOS UNSP CEREBELLAR ARTERY

I6339 CEREBRAL INFARCTION DUE TO THROMBOSIS OF OTH CEREBRAL ARTERY

I6340 CEREBRAL INFARCTION DUE TO EMBOLISM OF UNSP CEREBRAL ARTERY

I63411 CEREB INFRC DUE TO EMBOLISM OF RIGHT MIDDLE CEREBRAL ARTERY

I63412 CEREB INFRC DUE TO EMBOLISM OF LEFT MIDDLE CEREBRAL ARTERY

I63419 CEREB INFRC DUE TO EMBOLISM OF UNSP MIDDLE CEREBRAL ARTERY

I63421 CEREBRAL INFRC DUE TO EMBOLISM OF RIGHT ANT CEREBRAL ARTERY

I63422 CEREBRAL INFRC DUE TO EMBOLISM OF LEFT ANT CEREBRAL ARTERY

I63429 CEREBRAL INFRC DUE TO EMBOLISM OF UNSP ANT CEREBRAL ARTERY

I63431 CEREBRAL INFRC DUE TO EMBOLISM OF RIGHT POST CEREBRAL ARTERY

I63432 CEREBRAL INFRC DUE TO EMBOLISM OF LEFT POST CEREBRAL ARTERY

I63439 CEREBRAL INFRC DUE TO EMBOLISM OF UNSP POST CEREBRAL ARTERY

I63441 CEREBRAL INFARCTION DUE TO EMBOLISM OF RIGHT CEREBLR ARTERY

I6339 CEREBRAL INFARCTION DUE TO THROMBOSIS OF OTH CEREBRAL ARTERY

I63442 CEREBRAL INFARCTION DUE TO EMBOLISM OF LEFT CEREBLR ARTERY

I63449 CEREBRAL INFARCTION DUE TO EMBOLISM OF UNSP CEREBLR ARTERY

I6349 CEREBRAL INFARCTION DUE TO EMBOLISM OF OTHER CEREBRAL ARTERY

I6350 CEREB INFRC DUE TO UNSP OCCLS OR STENOS OF UNSP CEREB ARTERY

I63511 CEREB INFRC D/T UNSP OCCLS OR STENOS OF RIGHT MID CEREB ART

I63512 CEREB INFRC D/T UNSP OCCLS OR STENOS OF LEFT MID CEREB ART

I63519 CEREB INFRC D/T UNSP OCCLS OR STENOS OF UNSP MID CEREB ART

I63521 CEREB INFRC D/T UNSP OCCLS OR STENOS OF RIGHT ANT CEREB ART

I63522 CEREB INFRC D/T UNSP OCCLS OR STENOS OF LEFT ANT CEREB ART

I63529 CEREB INFRC D/T UNSP OCCLS OR STENOS OF UNSP ANT CEREB ART

I63531 CEREB INFRC D/T UNSP OCCLS OR STENOS OF RIGHT POST CEREB ART

I63532 CEREB INFRC D/T UNSP OCCLS OR STENOS OF LEFT POST CEREB ART

I63539 CEREB INFRC D/T UNSP OCCLS OR STENOS OF UNSP POST CEREB ART

I63541 CEREB INFRC DUE TO UNSP OCCLS OR STENOS OF RIGHT CEREBLR ART

I63542 CEREB INFRC DUE TO UNSP OCCLS OR STENOS OF LEFT CEREBLR ART

I63549 CEREB INFRC DUE TO UNSP OCCLS OR STENOS OF UNSP CEREBLR ART

I6359 CEREB INFRC DUE TO UNSP OCCLS OR STENOSIS OF CEREBRAL ARTERY

I636 CEREBRAL INFRC DUE TO CEREBRAL VENOUS THOMBOS, NONPYOGENIC

I638 OTHER CEREBRAL INFARCTION

I639 CEREBRAL INFARCTION, UNSPECIFIED



TOTAL HIP/KNEE ARTHROPLASTY

Measure Name: TKA/THA

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The hip and knee replacement measure includes index admissions for qualifying procedures and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a hip and/or knee replacement procedure, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a hip and/or knee replacement procedure, and who do not meet any exclusion criteria. Index admissions for hip and knee replacements were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.

ICD-9-CM PROCEDURE CODE DESCRIPTION

8151 TOTAL HIP REPLACEMENT

8154 TOTAL KNEE REPLACEMENT


OSR9019 REPLACEMENT OF R HIP JT WITH METAL, CEMENT, OPEN APPROACH

OSR901A REPLACEMENT OF R HIP JT WITH METAL, UNCEMENT, OPEN APPROACH

OSR901Z REPLACEMENT OF RIGHT HIP JOINT WITH METAL, OPEN APPROACH

OSR9029 REPLACE R HIP JT W METAL ON POLY, CEMENT, OPEN

OSR902A REPLACE R HIP JT WITH METAL ON POLY, UNCEMENT, OPEN

OSR902Z REPLACEMENT OF R HIP JT WITH METAL ON POLY, OPEN APPROACH

OSR9039 REPLACEMENT OF R HIP JT WITH CERAMIC, CEMENT, OPEN APPROACH

OSR903A REPLACEMENT OF R HIP JT WITH CERAMIC, UNCEMENT, OPEN APPROACH

OSR903Z REPLACEMENT OF RIGHT HIP JOINT WITH CERAMIC, OPEN APPROACH

OSR9049 REPLACE R HIP JT W CERAMIC ON POLY, CEMENT, OPEN

OSR904A REPLACE R HIP JT W CERAMIC ON POLY, UNCEMENT, OPEN

OSR904Z REPLACEMENT OF R HIP JT WITH CERAMIC ON POLY, OPEN APPROACH

OSR907Z REPLACEMENT OF RIGHT HIP JOINT WITH AUTOL SUB, OPEN APPROACH

OSR90J9 REPLACE OF R HIP JT WITH SYNTH SUB, CEMENT, OPEN APPROACH




OSR90JA REPLACE OF R HIP JT WITH SYNTH SUB, UNCEMENT, OPEN APPROACH

OSR90JZ REPLACE OF RIGHT HIP JOINT WITH SYNTH SUB, OPEN APPROACH

OSR90KZ REPLACEMENT OF R HIP JT WITH NONAUT SUB, OPEN APPROACH

OSRB019 REPLACEMENT OF L HIP JT WITH METAL, CEMENT, OPEN APPROACH

OSRB01A REPLACEMENT OF L HIP JT WITH METAL, UNCEMENT, OPEN APPROACH

OSRB01Z REPLACEMENT OF LEFT HIP JOINT WITH METAL, OPEN APPROACH

OSRB029 REPLACE L HIP JT W METAL ON POLY, CEMENT, OPEN

OSRB02A REPLACE L HIP JT W METAL ON POLY, UNCEMENT, OPEN

OSRB02Z REPLACEMENT OF L HIP JT WITH METAL ON POLY, OPEN APPROACH

OSRB039 REPLACEMENT OF L HIP JT WITH CERAMIC, CEMENT, OPEN APPROACH

OSRB03A REPLACE OF L HIP JT WITH CERAMIC, UNCEMENT, OPEN APPROACH

OSRB03Z REPLACEMENT OF LEFT HIP JOINT WITH CERAMIC, OPEN APPROACH

OSRB049 REPLACE L HIP JT W CERAMIC ON POLY, CEMENT, OPEN

OSRB04A REPLACE L HIP JT W CERAMIC ON POLY, UNCEMENT, OPEN

OSRB04Z REPLACEMENT OF HIP JT WITH CERAMIC ON POLY, OPEN APPROACH

OSRB07Z REPLACEMENT OF LEFT HIP JOINT WITH AUTOL SUB, OPEN APPROACH

OSRB0J9 REPLACE OF L HIP JT WITH SYNTH SUB, CEMENT, OPEN APPROACH

OSRB0JA REPLACE OF L HIP JT WITH SYNTH SUB, UNCEMENT, OPEN APPROACH

OSRB0JZ REPLACEMENT OF LEFT HIP JOINT WITH SYNTH SUB, OPEN APPROACH

OSRB0KZ REPLACEMENT OF LEFT HIP JOINT WITH NONAUT SUB, OPEN APPROACH

OSRC07Z REPLACEMENT OF R KNEE JT WITH AUTOL SUB, OPEN APPROACH

OSRC0J9 REPLACE OF R KNEE JT WITH SYNTH SUB, CEMENT, OPEN APPROACH

OSRC0JA REPLACE OF R KNEE JT WITH SYNTH SUB, UNCEMENT, OPEN APPROACH

OSRC0JZ REPLACEMENT OF R KNEE JT WITH SYNTH SUB, OPEN APPROACH

OSRC0KZ REPLACEMENT OF R KNEE JT WITH NONAUT SUB, OPEN APPROACH

OSRD07Z REPLACEMENT OF LEFT KNEE JOINT WITH AUTOL SUB, OPEN APPROACH

OSRD0J9 REPLACE OF L KNEE JT WITH SYNTH SUB, CEMENT, OPEN APPROACH

OSRD0JA REPLACE OF L KNEE JT WITH SYNTH SUB, UNCEMENT, OPEN APPROACH

OSRD0JZ REPLACEMENT OF LEFT KNEE JOINT WITH SYNTH SUB, OPEN APPROACH

OSRD0KZ REPLACEMENT OF L KNEE JT WITH NONAUT SUB, OPEN APPROACH

OSRT07Z REPLACE OF R KNEE JT, FEMORAL WITH AUTOL SUB, OPEN APPROACH

OSRT0J9 REPLACE R KNEE JT, FEMORAL W SYNTH SUB, CEMENT, OPEN

OSRT0JA REPLACE R KNEE JT, FEMORAL W SYNTH SUB, UNCEMENT, OPEN

OSRT0JZ REPLACE OF R KNEE JT, FEMORAL WITH SYNTH SUB, OPEN APPROACH

OSRT0KZ REPLACE OF R KNEE JT, FEMORAL WITH NONAUT SUB, OPEN APPROACH




OSRU07Z REPLACE OF L KNEE JT, FEMORAL WITH AUTOL SUB, OPEN APPROACH

OSRU0J9 REPLACE L KNEE JT, FEMORAL W SYNTH SUB, CEMENT, OPEN

OSRU0JA REPLACE L KNEE JT, FEMORAL W SYNTH SUB, UNCEMENT, OPEN

OSRU0JZ REPLACE OF L KNEE JT, FEMORAL WITH SYNTH SUB, OPEN APPROACH

OSRU0KZ REPLACE OF L KNEE JT, FEMORAL WITH NONAUT SUB, OPEN APPROACH

OSRV07Z REPLACE OF R KNEE JT, TIBIAL WITH AUTOL SUB, OPEN APPROACH

OSRV0J9 REPLACE R KNEE JT, TIBIAL W SYNTH SUB, CEMENT, OPEN

OSRV0JA REPLACE R KNEE JT, TIBIAL W SYNTH SUB, UNCEMENT, OPEN

OSRV0JZ REPLACE OF R KNEE JT, TIBIAL WITH SYNTH SUB, OPEN APPROACH

OSRV0KZ REPLACE OF R KNEE JT, TIBIAL WITH NONAUT SUB, OPEN APPROACH

OSRW07Z REPLACE OF L KNEE JT, TIBIAL WITH AUTOL SUB, OPEN APPROACH

OSRW0J9 REPLACE L KNEE JT, TIBIAL W SYNTH SUB,CEMENT, OPEN

OSRW0JA REPLACE KNEE JT, TIBIAL W SYNTH SUB, UNCEMENT, OPEN

OSRW0JZ REPLACE OF L KNEE JT, TIBIAL WITH SYNTH SUB, OPEN APPROACH

OSRW0KZ REPLACE OF L KNEE JT, TIBIAL WITH NONAUT SUB, OPEN APPROACH



CORONARY ARTERY BYPASS GRAFTING

Measure Name: CABG

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The CABG measure includes index admissions for qualifying procedures and readmissions for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital with a CABG procedure, and who do not meet any of the exclusion criteria. Measures were calculated using discharge records from participating hospitals.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital with a CABG procedure, and who do not meet any exclusion criteria listed below. Index admissions for CABG were identified by the ICD-9-CM and ICD-10-CM (for discharges on or after Oct. 1, 2015) codes as follows.


36.10 AORTOCORONARY BYPASS FOR HEART REVASCULARIZATION, NOT OTHERWISE SPECIFIED

36.11 (AORTO) CORONARY BYPASS OF ONE CORONARY ARTERY

36.12 (AORTO) CORONARY BYPASS OF TWO CORONARY ARTERIES

36.13 (AORTO) CORONARY BYPASS OF THREE CORONARY ARTERIES

36.14 (AORTO) CORONARY BYPASS OF FOUR OR MORE CORONARY ARTERIES

36.15 SINGLE INTERNAL MAMMARY-CORONARY ARTERY BYPASS

36.16 DOUBLE INTERNAL MAMMARY-CORONARY ARTERY BYPASS

36.17 ABDOMINAL-CORONARY ARTERY BYPASS

36.19 OTHER BYPASS ANASTOMOSIS FOR HEART REVASCULARIZATION


0210093 BYPASS 1 COR ART FROM COR ART WITH AUTOL VN, OPEN APPROACH

0210098 BYPASS 1 COR ART FROM R INT MAMMARY W AUTOL VN, OPEN

0210099 BYPASS 1 COR ART FROM L INT MAMMARY W AUTOL VN, OPEN

021009C BYPASS 1 COR ART FROM THOR ART WITH AUTOL VN, OPEN APPROACH

021009F BYPASS 1 COR ART FROM ABD ART WITH AUTOL VN, OPEN APPROACH




021009W BYPASS 1 COR ART FROM AORTA WITH AUTOL VN, OPEN APPROACH

02100A3 BYPASS 1 COR ART FROM COR ART WITH AUTOL ART, OPEN APPROACH

02100A8 BYPASS 1 COR ART FROM R INT MAMMARY W AUTOL ART, OPEN

02100A9 BYPASS 1 COR ART FROM L INT MAMMARY W AUTOL ART, OPEN

02100AC BYPASS 1 COR ART FROM THOR ART WITH AUTOL ART, OPEN APPROACH

02100AF BYPASS 1 COR ART FROM ABD ART WITH AUTOL ART, OPEN APPROACH

02100AW BYPASS 1 COR ART FROM AORTA WITH AUTOL ART, OPEN APPROACH

02100J3 BYPASS 1 COR ART FROM COR ART WITH SYNTH SUB, OPEN APPROACH

02100J8 BYPASS 1 COR ART FROM R INT MAMMARY W SYNTH SUB, OPEN

02100J9 BYPASS 1 COR ART FROM L INT MAMMARY W SYNTH SUB, OPEN

02100JC BYPASS 1 COR ART FROM THOR ART WITH SYNTH SUB, OPEN APPROACH

02100JF BYPASS 1 COR ART FROM ABD ART WITH SYNTH SUB, OPEN APPROACH

02100JW BYPASS 1 COR ART FROM AORTA WITH SYNTH SUB, OPEN APPROACH

02100K3 BYPASS 1 COR ART FROM COR ART WITH NONAUT SUB, OPEN APPROACH

02100K8 BYPASS 1 COR ART FROM R INT MAMMARY W NONAUT SUB, OPEN

02100K9 BYPASS 1 COR ART FROM L INT MAMMARY W NONAUT SUB, OPEN

02100KC BYPASS 1 COR ART FROM THOR ART W NONAUT SUB, OPEN

02100KF BYPASS 1 COR ART FROM ABD ART WITH NONAUT SUB, OPEN APPROACH

02100KW BYPASS 1 COR ART FROM AORTA WITH NONAUT SUB, OPEN APPROACH

02100Z3 BYPASS CORONARY ARTERY, ONE SITE FROM COR ART, OPEN APPROACH

02100Z8 BYPASS 1 COR ART FROM R INT MAMMARY, OPEN APPROACH

02100Z9 BYPASS 1 COR ART FROM L INT MAMMARY, OPEN APPROACH

02100ZC BYPASS 1 COR ART FROM THOR ART, OPEN APPROACH

02100ZF BYPASS CORONARY ARTERY, ONE SITE FROM ABD ART, OPEN APPROACH




























02110Z3 BYPASS 2 COR ART FROM COR ART, OPEN APPROACH




02110ZF BYPASS 2 COR ART FROM ABD ART, OPEN APPROACH




























02120Z3 BYPASS 3 COR ART FROM COR ART, OPEN APPROACH




02120ZF BYPASS 3 COR ART FROM ABD ART, OPEN APPROACH

0213093 BYPASS 4+ COR ART FROM COR ART WITH AUTOL VN, OPEN APPROACH

0213098 BYPASS 4+ COR ART FROM R INT MAMMARY W AUTOL VN, OPEN

0213099 BYPASS 4+ COR ART FROM L INT MAMMARY W AUTOL VN, OPEN

021309C BYPASS 4+ COR ART FROM THOR ART WITH AUTOL VN, OPEN APPROACH

021309F BYPASS 4+ COR ART FROM ABD ART WITH AUTOL VN, OPEN APPROACH

021309W BYPASS 4+ COR ART FROM AORTA WITH AUTOL VN, OPEN APPROACH

02130A3 BYPASS 4+ COR ART FROM COR ART WITH AUTOL ART, OPEN APPROACH

02130A8 BYPASS 4+ COR ART FROM R INT MAMMARY W AUTOL ART, OPEN

02130A9 BYPASS 4+ COR ART FROM L INT MAMMARY W AUTOL ART, OPEN

02130AC BYPASS 4+ COR ART FROM THOR ART W AUTOL ART, OPEN

02130AF BYPASS 4+ COR ART FROM ABD ART WITH AUTOL ART, OPEN APPROACH

02130AW BYPASS 4+ COR ART FROM AORTA WITH AUTOL ART, OPEN APPROACH

02130J3 BYPASS 4+ COR ART FROM COR ART WITH SYNTH SUB, OPEN APPROACH

02130J8 BYPASS 4+ COR ART FROM R INT MAMMARY W SYNTH SUB, OPEN

02130J9 BYPASS 4+ COR ART FROM L INT MAMMARY W SYNTH SUB, OPEN

02130JC BYPASS 4+ COR ART FROM THOR ART W SYNTH SUB, OPEN

02130JF BYPASS 4+ COR ART FROM ABD ART WITH SYNTH SUB, OPEN APPROACH

02130JW BYPASS 4+ COR ART FROM AORTA WITH SYNTH SUB, OPEN APPROACH

02130K3 BYPASS 4+ COR ART FROM COR ART W NONAUT SUB, OPEN

02130K8 BYPASS 4+ COR ART FROM R INT MAMMARY W NONAUT SUB, OPEN

02130K9 BYPASS 4+ COR ART FROM L INT MAMMARY W NONAUT SUB, OPEN

02130KC BYPASS 4+ COR ART FROM THOR ART W NONAUT SUB, OPEN

02130KF BYPASS 4+ COR ART FROM ABD ART W NONAUT SUB, OPEN




02130KW BYPASS 4+ COR ART FROM AORTA WITH NONAUT SUB, OPEN APPROACH

02130Z3 BYPASS 4+ COR ART FROM COR ART, OPEN APPROACH

02130Z8 BYPASS 4+ COR ART FROM R INT MAMMARY, OPEN APPROACH

02130Z9 BYPASS 4+ COR ART FROM L INT MAMMARY, OPEN APPROACH

02130ZC BYPASS 4+ COR ART FROM THOR ART, OPEN APPROACH

02130ZF BYPASS 4+ COR ART FROM ABD ART, OPEN APPROACH



HOSPITAL-WIDE READMISSIONS

Measure Name: HWR

Measure Description: 30-day risk-standardized readmission rates and ratios using CMS methodology with and without sociodemographic factors. The hospital-wide measure includes readmissions for any cause for any cause to an acute care hospital within 30 days of discharge from an acute care hospital.

Numerator Statement: Patients, ages 18 and older, who were readmitted for any reason to an acute care hospital within 30 days of discharge from an acute care hospital, and who do not meet any exclusion criteria listed below. Measures were calculated using discharge records from participating hospitals. Index admissions for hospital-wide readmissions include almost all inpatient discharges.

Denominator Statement: All patients, ages 18 and older, discharged from an acute care hospital, and who do not meet the exclusion criteria.



ICD-10 TRANSITIONAL REPORTING

WinQI and ICD-10

Hospitals transitioned to reporting ICD-10 diagnosis codes for all administrative claims effective Oct. 1, 2015. The Agency for Healthcare Research and Quality has not yet released software that can use ICD-10 diagnosis codes to calculate AHRQ quality indicators. Therefore, HIDI will be translating ICD-10 diagnosis codes to ICD-9 diagnosis codes to allow for processing through AHRQ’s current WinQI software (version 5.0).

SUMMARY

HIDI has begun to evaluate the differences observed across quarters in AHRQ measures based on discharge data before and after the ICD-10 change. HIDI gauged the level of incompleteness of the federal fiscal year 2016 hospital discharge input file, as well as the associated numerator and denominator counts from the AHRQ WinQI output, pre- and post-ICD-10. Measure-specific summary statistics were produced to determine the level of change observed between ICD-9 and ICD-10 time periods; graphic representations of these data appear in the HIDI AHRQ Measures Transition Appendix.

In aggregate and at a measure-specific level, numerator and denominator magnitude of AHRQ quality indicators aligned with recent data points (see Charts 1a, 1b and 1c). The changes in numerator and denominator volume were not different in terms of direction or relativity versus data points observed throughout the last 12 quarters.

Chart 1a



Chart 1b

Chart 1c



The federal fiscal year 2016 first quarter HIDI discharge file was observed to be possibly somewhat incomplete — perhaps about 5 percent short of expected, but it reached similar lows in the third and fourth quarters of FFY 2014 (see Chart 2). Other observed or unobserved trend divergences could be remnants of the built-in partial heterogeneity between ICD-9 and ICD-10. Additional intervening variables could be the lack of ICD-10 coding experience from MHA members’ coders, which may undergo correction throughout time, as well as the fact that the quarterly ICD-10 data point stands alone, compared to 12 prior quarters of ICD-9 trend produced under WinQI version 5.0.

Chart 2

Some measures were found to have an observed rate for Q1 FFY 2016 that was either higher or lower than at any other point in the previous 12 quarters (IQI-171 [17A], IQI-18, IQI-21, IQI-22, NQI-3, PDI-1, PSI-11, PSI-13). However, every one of these instances appeared to follow an established trend and no QI FFY 2016 measures violated the three standard deviation upper/lower limits. Comparatively, it’s noteworthy to mention that three ICD-9-based measures (pre-FFY 2016) produced data points that violated the three standard deviation upper/lower limit (PSI 17, PSI 18, PSI 19).

No alarming observations have been uncovered that would suggest GEM-coded Q1 FFY 2016 diagnoses are problematic in terms of AHRQ WinQI version 5.0 processing. However, the heterogeneity of the diagnostic sets suggests that there could be an observable difference in quality indicator rates when ICD-10-compliant risk-adjusted rate-producing software becomes available. Review will continue as future quarters of discharge data become available.

HIDI AHRQ Measures Transition Appendix4/28/2016

0.038999 0.040591738

IQI 8 Esophageal Resection Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 8 Esophageal Resection Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

Q1FFY2013 Q2FFY2013 Q3FFY2013 Q4FFY2013 Q1FFY2014 Q2FFY2014 Q3FFY2014 Q4FFY2014 Q1FFY2015 Q2FFY2015 Q3FFY2015 Q4FFY2015 Q1FFY2016

Observed Rate UL LL Linear (Observed Rate) 0

5

10

15

20

25

30

35

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

1

0.015662 0.016301111

PSI 4E Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum E - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4E Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum E - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%



50

100

150

200

250

300

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

2

0.03269 0.034025255

PSI 4D Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum D - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4D Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum D - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%



50

100

150

200

250

300

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

3

0.022364 0.023276712

PSI 4C Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4C Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%



50

100

150

200

250

300

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

4

0.009492 0.009879429

PSI 4B Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4B Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%



100

200

300

400

500

600

700

800

900

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

5

0.010286 0.010706336

PSI 4A Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4A Death Rate among Surgical Inpatients with Serious Treatable Complications Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%



50

100

150

200

250

300

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

6

0.004013 0.0041772

PSI 19 Obstetric Trauma Rate - Vaginal Delivery Without Instrument - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 19 Obstetric Trauma Rate - Vaginal Delivery Without Instrument - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

7

0.027549 0.02867432

PSI 18 Obstetric Trauma Rate - Vaginal Delivery With Instrument - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 18 Obstetric Trauma Rate - Vaginal Delivery With Instrument - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%



100

200

300

400

500

600

700

800

900

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

8

0.00071 0.000738864

PSI 17 Birth Trauma Rate - Injury to Neonate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 17 Birth Trauma Rate - Injury to Neonate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

9

#DIV/0! #DIV/0!

PSI 16 Transfusion Reaction Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 16 Transfusion Reaction Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%



0

0

0

0

1

1

1

1

1

1

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

10

0.000258 0.00026897

PSI 15 Accidental Puncture or Laceration Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 15 Accidental Puncture or Laceration Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%



20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

11

0.000774 0.000805545

PSI 14 Postoperative Wound Dehiscence Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 14 Postoperative Wound Dehiscence Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

0.35%

0.40%

0.45%



1,000

2,000

3,000

4,000

5,000

6,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

12

0.00149 0.001550955

PSI 13 Postoperative Sepsis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 13 Postoperative Sepsis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

1.40%

1.60%

1.80%



500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

13

0.00071 0.000739431

PSI 12 Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 12 Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

0.80%

0.90%



5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

14

0.002287 0.002379882

PSI 11 Postoperative Respiratory Failure Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 11 Postoperative Respiratory Failure Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

1.40%

1.60%

1.80%

2.00%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

15

9.93E-05 0.000103372

PSI 10 Postoperative Physiologic and Metabolic Derangement Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 10 Postoperative Physiologic and Metabolic Derangement Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.02%

0.04%

0.06%

0.08%

0.10%

0.12%

0.14%

0.16%



5,000

10,000

15,000

20,000

25,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

16

0.000645 0.000671104

PSI 9 Perioperative Hemorrhage or Hematoma Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 9 Perioperative Hemorrhage or Hematoma Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

0.80%



5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

17

4.23E-05 4.39807E-05

PSI 8 Postoperative Hip Fracture Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 8 Postoperative Hip Fracture Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.00%

0.00%

0.01%

0.01%

0.01%

0.01%

0.01%

0.02%

0.02%

0.02%



5,000

10,000

15,000

20,000

25,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

18

5.92E-05 6.15923E-05

PSI 7 Central Venous Catheter-Related Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 7 Central Venous Catheter-Related Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.01%

0.01%

0.02%

0.02%

0.03%

0.03%

0.04%

0.04%



20,000

40,000

60,000

80,000

100,000

120,000

140,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

19

6.33E-05 6.58925E-05

PSI 6 Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 6 Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.01%

0.02%

0.03%

0.04%

0.05%

0.06%



20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

20

#DIV/0! #DIV/0!

PSI 5 Retained Surgical Item or Unretrieved Device Fragment Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 5 Retained Surgical Item or Unretrieved Device Fragment Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%



0

0

0

0

1

1

1

1

1

1

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

21

0.010049 0.010458912

PSI 4 Death Rate among Surgical Inpatients with Serious Treatable Complications - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

PSI 4 Death Rate among Surgical Inpatients with Serious Treatable Complications - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%



200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

22

0.000447 0.000465655

PSI 3 Pressure Ulcer Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 3 Pressure Ulcer Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%



5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

23

6.77E-05 7.04941E-05

PSI 2 Death Rate in Low-Mortality Diagnosis Related Groups (DRGs) - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPSI 2 Death Rate in Low-Mortality Diagnosis Related Groups (DRGs) - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.01%

0.02%

0.03%

0.04%

0.05%

0.06%



5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

24

0.000199 0.000207542

PDI 12 Central Venous Catheter-Related Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 12 Central Venous Catheter-Related Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.02%

0.04%

0.06%

0.08%

0.10%

0.12%

0.14%

0.16%

0.18%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

25

0.002308 0.002402258

PDI 11 Postoperative Wound Dehiscence Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 11 Postoperative Wound Dehiscence Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

0.80%

0.90%

1.00%



50

100

150

200

250

300

350

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

26

0.002498 0.002600477

PDI 10 Postoperative Sepsis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 10 Postoperative Sepsis Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

1.40%

1.60%

1.80%

2.00%



100

200

300

400

500

600

700

800

900

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

27

0.005234 0.005448119

PDI 9 Postoperative Respiratory Failure Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 9 Postoperative Respiratory Failure Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%



100

200

300

400

500

600

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

28

0.002634 0.002741911

PDI 8 Perioperative Hemorrhage or Hematoma Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 8 Perioperative Hemorrhage or Hematoma Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

1.40%

1.60%



100

200

300

400

500

600

700

800

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

29

#DIV/0! #DIV/0!

PDI 7 RACHS-1 Pediatric Heart Surgery Volume - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 7 RACHS-1 Pediatric Heart Surgery Volume - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%



0

0

0

0

1

1

1

1

1

1

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

30

0.010127 0.010540835

PDI 6 RACHS-1 Pediatric Heart Surgery Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 6 RACHS-1 Pediatric Heart Surgery Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%



50

100

150

200

250

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

31

7.58E-05 7.88977E-05

PDI 5 Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 5 Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.01%

0.01%

0.02%

0.02%

0.03%

0.03%

0.04%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

32

#DIV/0! #DIV/0!

PDI 3 Retained Surgical Item or Unretrieved Device Fragment Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 3 Retained Surgical Item or Unretrieved Device Fragment Count - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%



0

0

0

0

1

1

1

1

1

1

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

33

0.000697 0.000725904

PDI 2 Pressure Ulcer Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 2 Pressure Ulcer Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

0.35%



500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

34

0.000164 0.000170855

PDI 1 Accidental Puncture or Laceration Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsPDI 1 Accidental Puncture or Laceration Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.02%

0.04%

0.06%

0.08%

0.10%

0.12%



5,000

10,000

15,000

20,000

25,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

35

0.007119 0.007410121

NQI 3 Neonatal Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsNQI 3 Neonatal Blood Stream Infection Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%



100

200

300

400

500

600

700

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

36

0.000456 0.000474274

NQI 2 Neonatal Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsNQI 2 Neonatal Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

0.35%

0.40%

0.45%

0.50%



5,000

10,000

15,000

20,000

25,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

37

0.000291 0.000302957

NQI 1 Neonatal Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsNQI 1 Neonatal Iatrogenic Pneumothorax Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

-0.02%

0.00%

0.02%

0.04%

0.06%

0.08%

0.10%

0.12%



200

400

600

800

1,000

1,200

1,400

1,600

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

38

0.032853 0.034194659

IQI 9B Pancreatic Resection Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 9B Pancreatic Resection Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%



5

10

15

20

25

30

35

40

45

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

39

0.023454 0.024412029

IQI 9A Pancreatic Resection Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 9A Pancreatic Resection Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%



10

20

30

40

50

60

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

40

0.005538 0.005764641

IQI 17C Acute Stroke Mortality Rate Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 17C Acute Stroke Mortality Rate Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

41

0.016371 0.017039015

IQI 17B Acute Stroke Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 17B Acute Stroke Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%



100

200

300

400

500

600

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

42

0.026433 0.02751284

IQI 17A Acute Stroke Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 17A Acute Stroke Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%



20

40

60

80

100

120

140

160

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

43

0.006323 0.00658072

IQI 11D Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum D - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

IQI 11D Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum D - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%



50

100

150

200

250

300

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

44

0.097241 0.101211649

IQI 11C Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

IQI 11C Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum C - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%



2

4

6

8

10

12

14

16

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

45

0.054327 0.056545165

IQI 11B Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

IQI 11B Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum B - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%



5

10

15

20

25

30

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

46

0.121617 0.126583267

IQI 11A Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals

IQI 11A Abdominal Aortic Aneurysm (AAA) Repair Mortality Rate Stratum A - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%



1

2

3

4

5

6

7

8

9

10

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

47

0.011062 0.011513391

IQI 34 Vaginal Birth After Cesarean (VBAC) Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 34 Vaginal Birth After Cesarean (VBAC) Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

48

0.009581 0.009971791

IQI 33 Primary Cesarean Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 33 Primary Cesarean Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

49

0.005428 0.005649993

IQI 32 Acute Myocardial Infarction (AMI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 32 Acute Myocardial Infarction (AMI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

50

0.003644 0.00379282

IQI 31 Carotid Endarterectomy Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 31 Carotid Endarterectomy Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

1.40%

1.60%

1.80%



100

200

300

400

500

600

700

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

51

0.003522 0.00366533

IQI 30 Percutaneous Coronary Intervention (PCI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 30 Percutaneous Coronary Intervention (PCI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%



500

1,000

1,500

2,000

2,500

3,000

3,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

52

0.001208 0.001257056

IQI 25 Bilateral Cardiac Catheterization Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 25 Bilateral Cardiac Catheterization Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%



1,000

2,000

3,000

4,000

5,000

6,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

53

0.004353 0.004531188

IQI 24 Incidental Appendectomy in the Elderly Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 24 Incidental Appendectomy in the Elderly Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%



500

1,000

1,500

2,000

2,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

54

0.009229 0.009606221

IQI 23 Laparoscopic Cholecystectomy Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 23 Laparoscopic Cholecystectomy Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

81.00%

82.00%

83.00%

84.00%

85.00%

86.00%

87.00%

88.00%

89.00%

90.00%

91.00%



200

400

600

800

1,000

1,200

1,400

1,600

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

55

0.011145 0.01159962

IQI 22 Vaginal Birth After Cesarean (VBAC) Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 22 Vaginal Birth After Cesarean (VBAC) Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

56

0.008282 0.008620318

IQI 21 Cesarean Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 21 Cesarean Delivery Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

23.00%

24.00%

25.00%

26.00%

27.00%

28.00%

29.00%

30.00%

31.00%

32.00%



2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

57

0.004007 0.004170957

IQI 20 Pneumonia Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 20 Pneumonia Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%

5.00%



1,000

2,000

3,000

4,000

5,000

6,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

58

0.005302 0.005518017

IQI 19 Hip Fracture Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 19 Hip Fracture Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%

5.00%



200

400

600

800

1,000

1,200

1,400

1,600

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

59

0.003628 0.003776314

IQI 18 Gastrointestinal Hemorrhage Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 18 Gastrointestinal Hemorrhage Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%



500

1,000

1,500

2,000

2,500

3,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

60

0.00796 0.008285398

IQI 17 Acute Stroke Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 17 Acute Stroke Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

61

0.003407 0.003545748

IQI 16 Heart Failure Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 16 Heart Failure Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%



1,000

2,000

3,000

4,000

5,000

6,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

62

0.005214 0.005427205

IQI 15 Acute Myocardial Infarction (AMI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 15 Acute Myocardial Infarction (AMI) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%



500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

63

0.000495 0.000515647

IQI 14 Hip Replacement Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 14 Hip Replacement Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%



200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

64

0.00734 0.007639288

IQI 13 Craniotomy Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 13 Craniotomy Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%



200

400

600

800

1,000

1,200

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

65

0.003824 0.003980402

IQI 12 Coronary Artery Bypass Graft (CABG) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 12 Coronary Artery Bypass Graft (CABG) Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%



200

400

600

800

1,000

1,200

1,400

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

66

0.023437 0.0243937

IQI 9 Pancreatic Resection Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting HospitalsIQI 9 Pancreatic Resection Mortality Rate - Observed Rate, FFY2013 - FFY2016 (Q1) - HIDI-Reporting Hospitals Average Denominator Magnitude

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%



10

20

30

40

50

60

70

80

90

100

ICD-9 (FY 13-15) ICD-10 (Q1FY 16)

67

Documents

Hospital Industry Data Institute ICD-10 Transitional Strategy