Procedure codes: potential modifiers of diagnosis-related groups.
Hughes, John S
Date of Pub
Fetter, Robert B; Lichtenstein, Jeffrey
Proposals to make complexity-of-illness adjustments to the diagnosis-related group system have relied on secondary diagnosis
codes and additional clinical information obtained from the hospital record. Another potential mechanism for modifying diagnosis-related
groups involves the use of non-operating room procedure codes. The use of these codes has the advantage of reliably identifying
costly subgroups of patients and thus the potential to provide for fairer compensation to hospitals caring for the sickest
patients. There are a number of disadvantages, however, and therefore the criteria with which to evaluate procedures as potential
modifiers are suggested.
Comorbidity : Severity of Illness Index : Abstracting and Indexing/methods : Cardiovascular Diseases/economics : Diagnosis-Related
Groups/classification : Fees and Charges/statistics & numerical data : Hospitalization/economics : Human : Length of Stay/statistics
& numerical data : Prospective Payment System : Research : Respiration Disorders/economics : Support, U.S. Gov't, Non-P.H.S.
: United States