3 M Health Information Systems APR DRG Classification

3 M Health Information Systems 3 M Health Information S Underlying Principle of 3

3 M Health Information Systems 3 M Health Information S 3 M™ APR DRG

3 M Health Information Systems 3 M Health Information S Example of Progression of

3 M Health Information Systems Example of Progression of Risk of Mortality Subclass Risk

3 M Health Information Systems 3 M Health Information S SOI and ROM are

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3 M Health Information Systems APR DRG Classification Data Elements MDC (Major Diagnostic Category) Base APR DRG (316 base APR DRG categories) Four Severity of Illness Subclasses* Subclass Severity Four Risk of Mortality Subclasses Subclass Severity 1 Minor 2 Moderate 3 Major 4 Extreme * Severity subclasses have APR DRG weights for each subclass. 1 © 2013 3 M. All Rights Reserved.

3 M Health Information Systems 3 M Health Information S Underlying Principle of 3 M™ APR DRGs Severity of illness (SOI) and risk of mortality (ROM) are dependent on the patient’s underlying problem. High severity of illness and risk of mortality are characterized by multiple serious diseases and the interaction among those diseases. 2 © 2013 3 M. All Rights Reserved.

3 M Health Information Systems 3 M Health Information S 3 M™ APR DRG Assignment is Driven by: § Principal diagnosis § Procedures performed § All secondary diagnoses § Age § Gender 3 © 2013 3 M. All Rights Reserved.

3 M Health Information Systems 3 M Health Information S Example of Progression of Severity of Illness Subclass Severity Secondary Diagnosis of Of Illness Diabetes Mellitus 1 Minor 2 Moderat Diabetes with Renal e Manifestation (250. 4 x) Major Diabetes with Ketoacidosis (250. 1 x) Severe Diabetes with Hyperosmolar Coma (250. 2 x) 3 4 4 © 2013 3 M. All Rights Reserved. Uncomplicated Diabetes (250. 0 x)

3 M Health Information Systems Example of Progression of Risk of Mortality Subclass Risk of Mortality 1 Minor 2 3 4 5 Secondary Diagnosis of Cardiac Arrhythmias Premature beats (427. 60) Moderat Sinoatrial Node Dysfunction e (427. 81) Major Paroxysmal Ventricular Tachycardia (427. 1) Severe © 2013 3 M. All Rights Reserved. Ventricular Fibrillation (427. 41)

3 M Health Information Systems 3 M Health Information S SOI and ROM are Independent The severity of illness and risk of mortality subclass are calculated separately and may be different from each other. § Severity of Illness is a weight base § ROM is based on many factors including age & gender Acute Cholecystitis SOI = 3 Major severity of illness ROM = 1 Low risk of mortality 6 © 2013 3 M. All Rights Reserved.