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Episode Clinical Summary	Table of Contents				
ISCHEMIC HEART DISEASE (IHD)					
Episode Characteristic	Episode Information				
Episode Overview	"Ischemic heart disease (all): This episode includes clinically related services for patients  diagnosed with ischemic heart disease (IHD) on two different dates at least 30 days apart or with a treatment or service specific to IHD (e.g., coronary artery bypass graft) associated with an appropriate diagnosis code for the condition.  This episode includes patients with: 1) IHD without ACS as a primary diagnosis in an inpatient hospital; or 2) IHD with ACS as a primary diagnosis in an inpatient hospital.  This episode does not include patients with a first diagnosis in the evaluation year occurring in the inpatient hospital setting because these patients represent acute exacerbations of a chronic condition."				
Episode Subtype Overviews	"? IHD without ACS: This episode includes clinically related services for patients with ischemic heart disease (IHD) without any inpatient claim with a primary diagnosis of acute coronary syndrome (ACS).
? IHD with ACS: This episode includes clinically related services for patients with ischemic heart disease (IHD) with at least one inpatient claim with a primary diagnosis of acute coronary syndrome (ACS)."				
Episode Type	Chronic condition				
Trigger Rules	"? Non-PB E&M visit with a trigger principal ICD-9 diagnosis code followed by an E&M visit with a trigger ICD-9 diagnosis code at least 30 but no more than 450 days apart; or
? PB E&M visit with a trigger ICD-9  diagnosis code followed by an E&M visit with a trigger ICD-9  diagnosis code at least 30 but no more than 450 days apart; or
? Service in any setting with a trigger ICD-9  diagnosis code and with a CPT-4 code that is specific"				
Start Date	30 days before first E&M visit start date or trigger service date				
Grouping Rules	"Services occurring between the episode start and end date are grouped to the episode using the following grouping rules:
? Service only: Groups services with one of the specified procedure codes listed in the episode?s definition.
? Service-diagnosis pair: Groups services with one of the specified procedure codes only if paired with one of the specified diagnosis codes.
? Principal diagnosis only: Groups services with one of the specified diagnosis codes in the principal position.
The list of codes in the episode's definition can be found on the following page. "				
"Closing Rules
(End Date)"	Generally 4 quarters after trigger or upon change in patient eligibility				
End of Worksheet					
