MRCs Trump MCCs

The MS-DRG grouper includes a category for “Major Related Conditions” (MRC) associated with AIDS/HIV (see MDC 25 logic). There are 676 ICD-9-CM diagnosis codes that qualify as MRCs, code range 0031-486. The MRCs trump the MCCs, so an AIDS inpatient treated for community acquired pneumonia, (e.g., secondary diagnosis 486) does not group to MS-DRG 974, [...]

The Best Coding Reference Is

the Internet. Tell you friendly HIM vendor to discount the price before you sign on for another term of static coding reference. Or better yet, ask them to charge you only for the products you select. If you tell me that your coders aren’t on the Internet, then you need to find a new [...]

ARF and AKI

Acute kidney injury (AKI) and intrinsic ARF are now synonyms (as of 2006, according to the Journal of the American Society of Nephology). I have seen some AKI in inpatient charts and would expect to see more in the future. I’ve forwarded the info to NCHS to help get the index and tabular updated (looks [...]

The Administrative Data Problem

Two recent abstracts show the problem with using ICD-9-CM in administrative data. Sometimes its reliable, sometimes not.Case in point, a recent study on the condition of essential tremor, ICD-9-CM code 333.1. The code had a postive predictive value (PPV) of only 49%. Excluding Parkinsonism and dystonia only increased the PPV to 57%. Looks like coders [...]