Example of MS-DRG Grouper CC/MCC Review Methodology Using the Impact On Resource Use Data													
													
													
													
													
													
													
													
													
		SDX	DESCRIPTION	Level	CNT 1	C1 	CNT 2	C2	CNT 3	C3	TOTAL 		
		J441	Chronic obstructive pulmonary disease with (acute) exacerbation	CC	"272,101"	1.59	"865,004"	2.29	"369,345"	3.00	"1,506,450"		
													
													
													
													
													
													
													
=> Non-CC Subclass : cases with no other sdx codes on the CC or MCC list													
=> CC Subclass : cases with additional sdx codes on the CC list and no other codes on the MCC list													
=> MCC Subclass : cases with additional sdx codes on the MCC list													
=> X is the estimated subclass value from the data													
=> Y is an interpolation of the value of the actual average cost for the subclass between the estimated subclass													
        value and the next higher subclass value													
													
X	Low	High											
0	0	"<E(1,s)"	Significantly below expected value for the non-CC subclass										
1	"E(1,s)"	"<E(2,s)"	Approximately equal to expected values for the non-CC subclass										
2	"E(2,s)"	"<E(3,s)"	Approximately equal to expected values for the CC subclass										
2	"E(3,s)"	"<2E(3,s)"	Approximately equal to expected values for the MCC subclass										
3	">2E(3,s)"		Significantly above expected value for the MCC subclass										
													
			SDX J441 : Chronic obstructive pulmonary disease with (acute) exacerbation										
				Non-CC Subclass									
				X	Low	High		Actual Avg. Cost non-CC Subclass					"$18,265"
				0	0	"< $15,072"		"X = 1 since $18,265 is between $15,072 and $20,505"					
				1	"$15,072 "	"< $20,505"		Y = 0.59		"$20,505 - $15,072  = $5,433"			
				2	"$20,505 "	"< $39,211"				"$18,265 - $15,072  = $3,193"			
				3	"$39,211 "	"< $78,422"				"$3,193 / $5,433 = 0.59"			
				4	"> $78,422"								
													
				CC Subclass 									
				X	Low	High		Actual Avg. Cost CC Subclass					"$26,002"
				0	0	"< $15,072"		"X = 2 since $28,002 is between $20,505 and $39,211"					
				1	"$15,072 "	"< $20,505"		Y = 0.29		"$39,211 - $20,505  = $18,706"			
				2	"$20,505 "	"< $39,211"				"$26,002 - $20,505  = $5,497"			
				3	"$39,211 "	"< $78,422"				"$5,497/ $18,706 = 0.29"			
				4	"> $78,422"								
													
				MCC Subclass 									
				X	Low	High		Actual Avg. Cost MCC Subclass					"$39,222"
				0	0	"< $15,072"		"X = 3 since $39,222 is between $39,211 and $78,422"					
				1	"$15,072 "	"< $20,505"		Y = 0.00		"$78,422 - $39,211  = $39,211"			
				2	"$20,505 "	"< $39,211"				"$39,222 - $39,211  = $22"			
				3	"$39,211 "	"< $78,422"				"$22 / $39,211 = 0.00"			
				4	"> $78,422"								
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													
													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