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"Medicare Fee-For-Service
2012 Supplemental QRUR: Episodes of Care
Episode Definitions"												
"Revised August 2014
"												
Table of Contents												
"Episode Name
(Subtypes Indented)"	"Episode Abbreviation
(Sheet Name)"	"Link to
Episode Summary"	Link to Triggering and Grouping Codes									
"1. Acute coronary syndrome (ACS) (all)
    2. ACS without percutaneous coronary intervention (PCI)  
        /coronary artery bypass graft (CABG)
    3. ACS with PCI
    4. ACS with CABG"	ACS	Summary	Codes									
5. Cellulitis	Cellulitis	Summary	Codes									
6. Chronic atrial fibrillation/flutter	ChronicAfibFlutter	Summary	Codes									
7. Chronic congestive heart failure (CHF)	CHF	Summary	Codes									
8. Chronic obstructive pulmonary disease (COPD)/asthma	COPDAsthma	Summary	Codes									
"9. Acute COPD/asthma, inpatient exacerbation"	AcuteCOPDAsthma	Summary	Codes									
10. Gastrointestinal (GI) hemorrhage 	GIHem	Summary	Codes									
"11. Ischemic heart disease (IHD) (all)
    12. IHD without ACS
    13. IHD with ACS"	IHD	Summary	Codes									
14. Kidney/urinary tract infection	KidneyUTI	Summary	Codes									
"15. Pneumonia (all)
    16. Pneumonia without IP hospitalization
    17. Pneumonia with IP hospitalization  "	Pneumonia	Summary	Codes									
18. Bilateral cataract removal with lens implant 	BilateralCataract	Summary	Codes									
"19. Coronary artery bypass graft (CABG) (all)
    20. CABG without ACS"	CABG	Summary	Codes									
21. Hip replacement/revision	HipRepRev	Summary	Codes									
22. Knee replacement/revision	KneeRepRev	Summary	Codes									
23. Lumbar spine fusion/refusion	LumbarSpine	Summary	Codes									
"24. Percutaneous coronary intervention (PCI) (all)
    25. PCI without ACS"	PCI	Summary	Codes									
26. Permanent pacemaker system replacement/insertion	Pacemaker	Summary	Codes									
"
Code Types
For a given episode, the following code types may trigger or be used to group Medicare claims to the episode:
? International Classification of Diseases Ninth Revision (ICD-9) diagnosis code, sometimes aggregated to a 3-digit code (denoted as ""ICD-9 Diagnosis"" in this workbook)
? ICD-9 procedure codes (""ICD-9 Procedure"")
? Medicare-Severity Diagnosis-Related Group (""MS-DRG"")
? Healthcare Common Procedure Coding System (""HCPCS"")
? Current Procedural Terminology Version 4 (""CPT-4"")*
? Ambulatory Payment Classification (""APC"")
? Healthcare Cost and Utilization Project Clinical Classification Software for Services and Procedures (""CCS"")
? Revenue Center (""Revenue Center"")

*CPT is a registered trademark of the American Medical Association."												
Complete technical documentation for the 2012 Supplemental QRURs can be found in the Detailed Methods document located here.												
End of Worksheet												
												
												
