Hyponatremia Single SOI 2

3M™ APR DRG Assignment Report Page 1 of 16

3M Health Information Systems

3M™ APR DRG Assignment Report
APR DRG Version 26.1

Patient ID : - Sex : Female
Age in Years : 65 Status : 1 - Home
Days Mech Vent DMV 6 - No DMV
(DMV) : Option :

Grouper Results
MDC : 6 - DISEASES AND DISORDERS OF THE DIGESTIVE SYSTEM
All Patient Refined 253 - OTHER & UNSPECIFIED GASTROINTESTINAL
DRG : HEMORRHAGE
Severity of Illness : 2 - Moderate Patient Severity of Illness
Risk of Mortality : 1 - Minor Patient Risk of Mortality
Medical/Surgical DRG : Medical
Return Code : 0 - DRG assigned

Principal Diagnosis
5789 Gastrointest hemorr NOS (DRG)

Diagnosis Affect DRG Affect SOI Affect ROM Compl of Care
5789 Yes Yes Yes No

Secondary Diagnoses
41401 Crnry athrscl natve vssl
2761 Hyposmolality

Diagnosis Affect DRG Affect SOI Affect ROM Compl of Care
41401 No No No No
2761 No Yes Yes No

Procedures
9904 Packed cell transfusion

Procedure OR Affect DRG Affect SOI Affect ROM
9904 No No No No

APR DRG Assignment

Patient PDX 5789 used for DRG and SOI/ROM assignment

Phase 1
Advance to SOI Detail Advance to ROM Detail

file://C:Documents and SettingsGAHERN001Local SettingsTempAPRAssignmentRepo... 5/7/2009


Phase 1 Results MSL Steps 1-6 MML Steps 1-6
41401 1 1
2761 2 2

Phase 2

Phase 2 Results Steps 7-9
Maximum Severity level 2
Maximum Mortality level 1

Phase 3

Steps Phase 3 Results SOI ROM
10 PDX/DRG modification 2 1
11a DRG/Age modification 2 1
11b PDX/DRG/Age modification 2 1
11c DRG/BWT/Non-OR Proc modification - 1
12 DRG/Non-OR Proc modification 2 1
13 DRG/Proc modification 2 1
14 DRG/Multiple Proc modification 2 1
15 ECMO modification 2 -
16 PDX/DRG/Non-OR Proc modification 2 -
17 Multiple SDX modification 2 1
18 Final Severity of Illness/Risk of Mortality Subclass 2 1

Return to summary



APR DRG - Severity of Illness Detail
Key:
SSL = Standard Severity Level
MSL = Modified Severity Level
CSV = Category Subclass Value
X = Excluded diagnosis
D = Duplicate diagnosis

Diagnosis Code SSL Group Category CSV
PDX 5789 2 0 0 0
SDX 41401 1 519 161 1
SDX 2761 2 0 342 2

Phase 1 Results: Determine the Severity level of each individual
secondary diagnosis.

Step 1 : PDX/SDX Exclusions
Eliminate secondary diagnoses that are closely related with the principal
diagnosis.

Step 2 : SDX Default Level
Assign each secondary diagnosis to its standard severity level.

Step 3 : SDX Modification by Age
Modify the standard severity level of each secondary diagnosis based on
patient age.

Step 4 : SDX Modification by PDX and APR DRG
Modify the standard severity level of each secondary diagnosis in specific APR
DRG/PDX/SDX combinations. If the secondary diagnosis is closely related to
the principal diagnosis.

Step 5 : SDX Modification by APR DRG
Modify the standard severity level of each secondary diagnosis. If the
secondary diagnosis has a common presence in the APR DRG assigned.

Step 6 : SDX Modification by non-OR procedure
Modify the standard severity level of each secondary diagnosis. If a non-OR
procedure indicates a more extensive disease process within that diagnosis.

SOI - Steps
Diagnosis 1 2 3 4 5 6 MSL
41401 0 1 1 1 1 1 1
2761 0 2 2 2 2 2 2

Return to summary



Phase 2 Results: Determine the Base Severity of Illness subclass of
the Patient.

Step 7A : SDX/SDX Exclusions
Closely related secondary diagnoses are placed into groups together with
clinically similar diagnoses. If more than one secondary diagnosis from the
same group is present, then only the secondary diagnoses with the highest
severity of illness is preserved. All other secondary diagnoses in the group are
eliminated.
Number of SDX Groups : 1
Group Count HiMSL
519 1 1

Step 7B : Specific/General SDX/SDX Exclusions
Subsets of the groups in 7A are designated as "general secondary diagnosis
groups" (GenSDX) or "specific secondary diagnosis groups" (SpecsSDX). Each
specific secondary diagnosis group will have one or more general secondary
diagnosis groups associated with it.
If a diagnosis in a specific group is present, all diagnoses in the general
groups associated with the specific group will be eliminated. The one
exception is if the diagnosis in the general group creates an explicit secondary
diagnosis combination in Step 17; when this occurs, both the specific and
general groups are maintained. If the severity level of the diagnosis in the
general group is higher than the severity level of the diagnosis in the specific
group, the diagnosis in the general group is eliminated while the severity level
of the diagnosis in the specific group is increased to be equal to the severity
level of the diagnosis in the general group.

Step 7C : General/General SDX/SDX Exclusions
If there is no corresponding specific group diagnosis and there are diagnoses
in multiple general groups present that would have been eliminated had the
specific group been present, a hierarchy of general groups is used to eliminate
all but one of the diagnoses in the general groups. If any of the severity levels
of the diagnoses being eliminated is higher than the severity level of the
general group that is highest in the general group hierarchy, the severity level
of the diagnosis that is in the general group that is the highest in the
hierarchy is increased to the severity level of the eliminated diagnosis with
the highest severity level.

MSL at end of Step 7
DXcode Final MSL
41401 1
2761 2

Step 8 : Initial Patient Subclass
Compute a single overall base patient severity subclass value. The overall
base patient severity of illness subclass is set equal to the highest severity of
illness level of all the remaining secondary diagnoses.

Number of SDXs with MSL equal to level 1 : 1




Maximum Severity Subclass Value (8) : 2

Step 9 : Adjusted Patient Subclass
Action : None
Maximum Severity subclass (9) : 2

Return to summary

Phase 3 Results: Determine the final Severity of Illness subclass of
the patient.

Step 10 : Subclass modification by PDX and APR DRG
Compute a Modified Patient Severity Subclass based on the PDX/APR DRG
combination.
Modifications may be made to the severity of illness due to the clinical
implications of the principal diagnosis combined with the APR DRG.
The severity of illness subclass from Step 9 can be either increased or
decreased based on the specific combinations of Principal Diagnosis and APR
DRG.

APR DRG/PDX not included in Step 10, set to value in Step 9
PDX/APR DRG Modified Patient Severity Subclass Value (10) : 2

Step 11A : Subclass modification by APR DRG and Age
Compute a Modified Patient Severity Subclass based on the APR DRG/Age
combination.
decreased based on the specific combinations of APR DRG and Age.

APR DRG 253 not included in Step 11A, set to value in Step 9.
APR DRG/AGE Severity Subclass Value (11A) : 2

Step 11B : Subclass modification by PDX, APR DRG and Age
Compute a Modified Patient Severity Subclass based on the PDX/APR DRG
combination within the patient age range.
decreased based on the specific combinations of PDX, APR DRG and Age.

APR DRG / PDX not included in Step 11B, set to value in Step 9.
PDX/APR DRG/AGE Severity Subclass Value (11B) : 2

Step 11C : Not applicable

Step 12 : Subclass modification by APR DRG and non-OR procedure
Compute a Modified Patient Severity Subclass based on a combination of the
APR DRG and the presence of certain non-OR procedures which DO NOT affect
APR DRG assignment.
For some APR DRGs the presence of certain non-OR procedures indicates a
more severely ill patient.



decreased based on the specific combinations of APR DRG and non-OR
procedures.
If there is more than one non-OR procedure present that falls into this
category, the non-OR procedure/APR DRG combination which results in the
highest subclass is selected.

APR DRG 253 not included in Step 12, set to value in Step 9.
Non-OR/APR DRG Severity Subclass (12) : 2

Step 13 : Subclass modification by APR DRG and OR procedure
Compute a Modified Patient Severity Subclass based on a combination of the
APR DRG and the presence of certain OR procedures which affect APR DRG
assignment.
Within specific APR DRGs, some OR procedures are indicative of higher
severity of illness relative to the other OR procedures in the APR DRG.
Conversely, within specific APR DRGs, some OR procedures are indicative of
lower severity of illness.
decreased based on the specific combinations of APR DRG and OR procedures.
If there is more than one OR procedure present that falls into this category,
the OR procedure/APR DRG combination which results in the highest subclass
is selected.

OR Procedure/APR DRG Severity Subclass (13) : 2

Step 14 : Subclass modification by APR DRG and multiple procedures
Compute a Modified Patient Severity Subclass based on the existence of an
OR Procedure/Category combination.
Within specific APR DRGs some pairs of OR procedures are indicative of higher
severity of illness relative to the other patients in the APR DRG. There are
specific areas where multiple procedures are a significant determinant of
severity of illness. If one OR procedure category is listed for a specified APR
DRG, then the patient subclass value from Step 9 is increased.
If two OR procedure categories are listed but it does not define the APR DRG,
then the patient subclass value from Step 9 is increased.

Procedure Category Pair Severity Subclass (14) : 2

Step 15 : Subclass modification for ECMO
Compute a Modified Patient Severity Subclass based on a combination of APR
DRG and the presence of certain specified procedures.
This step is specific to the logic of how one APR DRG is defined, APR DRG 583
Neonate with ECMO.
For this APR DRG, some neonates have a major OR procedure(s) performed
which indicate a more severely ill patient. Those neonates who do not have a
major OR procedure(s) performed are at a significantly lower severity of
illness. If one or more major procedure(s) is present the highest subclass
value will be selected. For neonates without a major procedure the severity of
illness subclass value from Step 9 will decrease.



APR DRG 253 not included in Step 15, set to value in Step 9
OR procedure/APR DRG Severity Subclass (15) : 2

Step 16 : Subclass modification by APR DRG, PDX and non-OR procedure
Compute a Modified Patient Severity Subclass based on the presence of
certain non-OR procedure/PDX/APR DRG combinations.
Within an APR DRG, specific principal diagnoses in combination with certain
non-OR procedures indicate a more severely ill patient. If one of these
combinations is present, the severity of illness subclass from Step 9 can be
increased.
This step applies to a limited number of patients, mostly cancer patients
receiving chemotherapy or radiation therapy.

Non-OR/PDX/APR DRG Severity Subclass (16) : 2

Step 17 : Subclass modification for multiple SDXs
Compute a Modified Patient Subclass Value (MPSV) based on the presence of
specific combinations of categories of SDXs.
The presence of certain combinations of secondary diagnoses has a great
clinical significance, therefore, a minimum patient severity of illness subclass
greater than minor (1) is established if certain combinations of secondary
diagnoses are present. Each secondary diagnosis is assigned to a disease
category which are defined with varying levels of severity of illness. An
assignment process has been established to account for the interaction and
increased severity of these situations. Any secondary diagnosis for which the
MSL in Step 8 is less than the Category Subclass Value is excluded from this
step.

The table presented in Step 17 references secondary diagnosis categories and
severity level combinations. The results of the analysis for multiple interacting
diagnoses are presented in the table below. If a category combination is
present, and the conditions for that combination type as listed in the table are
met, then assign the modified patient severity subclass value as indicated in
the table. If a category combination is present, and the conditions for that
combination type as listed in the table are not met, then assign the modified
patient severity subclass value from Step 9.

Note : MDC 15 applies different logic for Step 17. If patients in APR DRGs 626
or 640 have multiple other problems, then a modified patient severity
subclass of 3 is set.

Combination Combination of SDX Additional Minimum
Type Categories SDX Required Subclass
1 (3) + (3) Two (3)s 4
2 (3) + (2) Two (3)s 4
3 (2) + (2) Two (2)s 3
4 (2) + (1) Two (2)s 3
5 (1) + (1) Two (1)s 2

6 Combo Cats for None 3
Neonate APR DRGs



626 and 640
11 (3) + (3) One (3) 4
13 (2) + (2) One (2) 3
15 (1) + (1) One (1) 2

No combination selected in Step 17, set to value in Step 9.
MPSV (17): 2

Step 18 : Final Patient Severity Subclass
Compute a Final Patient Severity Subclass Value based on the following steps
and hierarchy:
Step 10 Modified PDX/APR DRG patient subclass
Step 11A Modified APR DRG/Age patient subclass
Step 11B Modified PDX/APR DRG/Age patient subclass
Step 11C Not applicable
Step 12 Modified non-OR procedure/APR DRG subclass
Step 13 Modified OR procedure/APR DRG subclass
Step 14 Modified OR procedure pair/APR DRG subclass
Step 15 Modified ECMO/APR DRG subclass
Step 16 Modified non-OR procedure/APR DRG/PDX/subclass
Step 17 Modified patient severity subclass value (MPSV) from SDX
category combinations

The above 10 modified subclass results are used to compute the final subclass
value based on the following hierarchy. In the hierarchy table, the base
severity subclass refers to the subclass from Step 9. The maximum Phase III
decrease means the maximum decrease of any Phase III step that decreases
the severity subclass. The maximum Phase III increase means the maximum
III step that increases the severity subclass. "Actual" increase or decrease
means that the Step respectively increased or decreased the severity
subclass. "Tried" increase or decrease means that the logic of the Step would
have respectively increased or decreased the severity subclass but the
severity subclass was at its respective maximum or minimum allowed by the
Step.

Tried Actual Value
Actual Step Values
Step 10 Modified PDX/APR DRG Subclass No No 2
Step 11A Modified APR DRG/Age Subclass No No 2
Step 11B Modified PDX/APR DRG/Age Subclass No No 2
Step 11C Not applicable
Step 12 Modified non-OR/APR DRG Subclass No No 2
Step 13 Modified Procedure/APR DRG Subclass No No 2
Step 14 Modified Procedure Pair/APR DRG Subclass No No 2
Step 15 Modified ECMO/APR DRG Subclass No No 2
Step 16 Modified non-OR/APR DRG/PDX Subclass No No 2
Step 17 MPSV No No 2

Step Result Step Result Final Severity Subclass

15 Actual or Tried Decrease - -
Base severity subclass



minus one
13 Actual or Tried Decrease - - plus maximum Phase III
severity increase
13 Actual or Tried Decrease 12,14,16,17 Actual Increase minus maximum Phase III
decrease plus one
13 Actual or Tried Decrease - - minus maximum Phase III
decrease
10,12,14,17 Actual or Tried Decrease - - plus maximum Phase III
increase
10 Actual Decrease 11 Actual Increase minus maximum Phase III
increase
10 Tried Decrease 11 Actual Increase Base severity subclass
decrease
11 Actual or Tried Increase - - plus maximum Phase III
increase
decrease

Patient Severity of Illness Subclass Value : 2

Return to summary



APR DRG - Risk of Mortality Detail
Key:
SML = Standard Mortality Level
MML = Modified Mortality Level
CSV = Category Subclass Value
X = Excluded diagnosis
D = Duplicate diagnosis

Diagnosis Code SML Group Category CSV
PDX 5789 1 0 0 0
SDX 41401 1 519 161 1
SDX 2761 2 0 342 2

Phase 1 Results: Determine the Risk of Mortality level of each
individual secondary diagnosis.

Step 1 : PDX/SDX Exclusions
Eliminate secondary diagnoses that are closely related with the principal
diagnosis.

Step 2 : SDX Default Level
Assign each secondary diagnosis to its standard risk of mortality level.

Step 3 : SDX Modification by Age
Modify the standard risk of mortality level of each secondary diagnosis based
on patient age.

Step 4 : SDX Modification by PDX and APR DRG
Modify the standard risk of mortality level of each secondary diagnosis in
specific APR DRG/PDX/SDX combinations. If the secondary diagnosis is closely
related to the principal diagnosis.

Step 5 : SDX Modification by APR DRG
Modify the standard risk of mortality level of each secondary diagnosis. If the
secondary diagnosis has a common presence in the APR DRG assigned.

Step 6 : SDX Modification by non-OR procedure
Modify the standard risk of mortality level of each secondary diagnosis. If the
non-OR procedure indicates a more extensive disease process within that
diagnosis.

ROM - Steps
Diagnosis 1 2 3 4 5 6 MML
41401 0 1 1 1 1 1 1
2761 0 2 2 2 2 2 2

Return to summary



Phase 2 Results: Determine the base Risk of Mortality subclass of the
patient.

Step 7 A: SDX/SDX Exclusions
Closely related secondary diagnoses are placed into groups together with
clinically similar diagnoses. If more than one secondary diagnosis from the
same group is present, then only the secondary diagnosis with the highest
risk of mortality is preserved. All other secondary diagnoses in the group are
eliminated.
Number of SDX groups:1
Group Count HiMML
519 1 1

Step 7B : Specific/General SDX/SDX Exclusions
Subsets of the groups in 7A are designated as "general secondary diagnosis
groups" (GenSDX) or "specific secondary diagnosis groups" (SpecsSDX). Each
specific secondary diagnosis group will have one or more general secondary
diagnosis groups associated with it.
If a diagnosis in a specific group is present, all diagnoses in the general
groups associated with the specific group will be eliminated. The one
exception is if the diagnosis in the general group creates an explicit secondary
diagnosis combination in Step 17; when this occurs, both the specific and
general groups are maintained. If the risk of mortality level of the diagnosis in
the general group is higher than the risk of mortality level of the diagnosis in
the specific group, the diagnosis in the general group is eliminated while the
risk of mortality level of the diagnosis in the specific group is increased to be
equal to the risk of mortality level of the diagnosis in the general group.

Step 7C : General/General SDX/SDX Exclusions
If there is no corresponding specific group diagnosis and there are diagnoses
in multiple general groups present that would have been eliminated had the
specific group been present, a hierarchy of general groups is used to eliminate
all but one of the diagnoses in the general groups. If any of the risk of
mortality levels of the diagnoses being eliminated is higher than the risk of
mortality level of the general group that is highest in the general group
hierarchy, the risk of mortality level of the diagnosis that is in the general
group that is the highest in the hierarchy is increased to the risk of mortality
level of the eliminated diagnosis with the highest risk of mortality level.

MML at end of Step 7
DXcode Final MML
41401 1
2761 2

Step 8 : Initial Patient Subclass
Compute a single overall base patient risk of mortality subclass value. The
overall base patient risk of mortality subclass value is set equal to the highest
risk of mortality level of all the remaining secondary diagnoses.

Number of SDXs with MML equal to level 1 : 1



Maximum Risk of Mortality Subclass Value (8) : 2

Step 9 : Adjusted Patient Subclass
If the Maximum Risk of Mortality Subclass is 2.

Condition Action
There are two or more secondary diagnosis at risk
None
of mortality level 2.
There is only one secondary diagnosis at risk of
None
mortality level 2 and that diagnosis is on List E.
There is none or only one secondary diagnosis at
Subtract 1
risk of mortality level 2
Action : Subtract 1
Maximum Risk of Mortality Subclass (9) : 1

Return to summary

Phase 3 Results: Determine the final Risk of Mortality subclass of the
patient.

Step 10 : Subclass modification by PDX and APR DRG
Compute a Modified Patient Risk of Mortality Subclass based on the PDX/APR
DRG combination.
Modifications may be made to the risk of mortality due to the clinical
implications of the principal diagnosis combined with the APR DRG.
The risk of mortality subclass from Step 9 can be either increased or
decreased based on the specific combinations of Principal Diagnosis and APR
DRG.

APR DRG /PDX not included in Step 10, set to value in Step 9.
PDX/APR DRG Modified Patient Risk of Mortality Subclass Value (10) :
1

Step 11A : Subclass modification by APR DRG and Age
Compute a Modified Patient Risk of Mortality Subclass based on the APR
DRG/Age combination.
decreased based on the specific combinations of APR DRG and Age.

APR DRG 253 not included in Step 11A, set to value in Step 9.
APR DRG/AGE Risk of Mortality Subclass Value (11A) : 1

Step 11B : Subclass modification by PDX, APR DRG and Age
Compute a Modified Patient Risk of Mortality Subclass based on the PDX/APR
DRG combination within the patient age range.
decreased based on the specific combinations of PDX, APR DRG and Age.



APR DRG/PDX not included in Step 11B, set to value in Step 9.
PDX/APR DRG/AGE RIsk of Mortality Subclass Value (11B) : 1

Subclass modification by APR DRG, Birth Weight and non-OR
Step 11C :
Procedure.
Compute a Modified Patient Risk of Mortality Subclass based on the APR
DRG/birth weight/non-OR procedures of the patient.
decreased based on the specific combinations of APR DRG, birth weight and
non-OR procedures.
This step examines the relationship between APR DRG and birth weight and
the presence/absence of non-OR procedures for extremely low birth weight
neonates in MDC 15.

APR DRG 253 not included in Step 11C, set to value in Step 9.
APR DRG/Birth Weight/AGE Risk of Mortality Subclass Value(11C) : 1

Step 12 : Subclass modification by APR DRG and non-OR procedure
Compute a Modified Patient Mortality Subclass based on a combination of the
APR DRG and the presence of certain non-OR procedures which DO NOT affect
APR DRG assignment.
For some APR DRGs the presence of certain non-OR procedures indicates a
more severely ill patient.
decreased based on the specific combinations of APR DRG and non-OR
procedures.
If there is more than one non-OR procedure present that falls into this
category, the non-OR procedure/APR DRG combination which results in the
highest subclass is selected.

Non-OR/APR DRG Mortality Subclass (12) : 1

Step 13 : Subclass modification by APR DRG and OR procedure
Compute a Modified Patient Risk of Mortality Subclass based on a combination
of the APR DRG and the presence of certain OR procedures which affect APR
DRG assignment.
Within specific APR DRGs, some OR procedures are indicative of higher risk of
mortality relative to the other OR procedures in the APR DRG. Conversely,
within specific APR DRGs, some OR procedures are indicative of lower risk of
mortality.
decreased based on the specific combinations of APR DRG and OR procedures.
If there is more than one OR procedure present that falls into this category,
the OR procedure/APR DRG combination which results in the highest subclass
is selected.

OR Procedure/APR DRG Risk of Mortality Subclass (13) : 1

Step 14 : Subclass modification by APR DRG and multiple procedures

Compute a Modified Patient Risk of Mortality Subclass based on the existence



of an OR Procedure/Category combination.
Within specific APR DRGs some pairs of OR procedures are indicative of higher
risk of mortality relative to the other patients in the APR DRG. There are
specific areas where multiple procedures are a significant determinant of risk
of mortality. If one OR procedure category is listed for a specified APR DRG,
then the patient subclass value from Step 9 is increased. If two OR procedure
categories are listed but it does not define the APR DRG, then the patient
subclass value from Step 9 is increased.

Procedure Category Pair Risk of Mortality Subclass (14) : 1

Step 15 : Not applicable
Step 16 : Not applicable

Step 17 : Subclass modification for multiple SDXs
Compute a Modified Patient Subclass Value (MPSV) based on the presence of
specific combinations of categories of SDXs.
The presence of certain combinations of secondary diagnoses has great
clinical significance, therefore, a minimum patient risk of mortality subclass
greater than minor (1) is established if certain combinations of secondary
diagnoses are present. Each secondary diagnosis is assigned to a disease
category are defined with varying levels of risk of mortality. An assignment
process has been established to account for the interaction and increased risk
of mortality of these situations. Any secondary diagnosis for which the MML in
Step 8 is less than the Category Subclass Value is excluded from this step.

The table presented in Step 17 references secondary diagnosis categories and
risk of mortality level combinations. The results of the analysis for multiple
interacting diagnoses are presented in the table below. If a category
combination is present, and the conditions for that combination type as listed
in the table are met, then assign the modified patient risk of mortality
subclass value as indicated in the table. If a category combination is present,
and the conditions for that combination type as listed in the table are not met,
then assign the modified patient risk of mortality subclass value from Step 9.
Note: MDC 15 applies different logic for Step 17. If patients in APR DRGs 626
or 640 have multiple other problems, then a modified patient mortality
subclass of 3 is set.

Combination Combination of SDX Additional SDX Minimum
Type Categories Required Subclass
1 (3) + (3) Two (3)s 4
2 (3) + (2) Two (3)s 4
3 (2) + (2) Two (2)s 3
4 (2) + (1) Two (2)s 3
5 (1) + (1) Two (1)s 2
11 (3) + (3) One (3) 4
13 (2) + (2) One (2) 3
15 (1) + (1) One (1) 2

No combination selected in Step 17, set to value in Step 9.
MPSV (17) : 1



Step 18 : Final Patient Risk of Mortality Subclass
Compute a Final Patient Risk of Mortality Subclass value based on the
following steps and hierarchy:
Step 10 Modified PDX/APR DRG patient subclass
Step 11A Modified APR DRG/Age patient subclass
Step 11B Modified PDX/APR DRG/Age patient subclass
Step 11C Modified APR DRG, Birth Weight and non-OR Procedure
Step 12 Modified non-OR procedure/APR DRG subclass
Step 13 Modified OR procedure/APR DRG subclass
Step 14 Modified OR procedure pair/APR DRG subclass
Step 15 Not applicable
Step17 Modified patient mortality subclass value (MPSV) from SDX
category combinations

The above 10 modified subclass results are used to compute the final subclass
value based on the following hierarchy. In the hierarchy table, the base risk of
mortality subclass refers to the subclass from Step 9. The maximum Phase III
decrease means the maximum decrease of Phase III step that decreases the
risk of mortality subclass. The maximum Phase III increase means the
maximum III step that increases the risk of mortality subclass. "Actual"
increase or decrease means that the Step respectively increased or decreased
the risk of mortality subclass. "Tried" increase or decrease means that the
logic of the Step would have respectively increased or decreased the risk of
mortality subclass but the risk of mortality subclass was at its respective
maximum or minimum allowed by the Step.

Tried Actual Value
Actual Step Values
Step 10 Modified PDX/APR DRG Subclass No No 1
Step 11A Modified APR DRG/Age Subclass No No 1
Step 11B Modified PDX/APR DRG/Age Subclass No No 1
Modified APR DRG, Birth Weight and non-OR
Step 11C No No 1
Procedure subclass
Step 12 Modified non-OR/APR DRG Subclass No No 1
Step 13 Modified Procedure/APR DRG Subclass No No 1
Step 14 Modified Procedure Pair/APR DRG Subclass No No 1
Step 17 MPSV No No 1

Final Risk of Mortality
Step Result Step Result
Subclass
Base Risk of Mortality
subclass plus maximum
11C Actual or Tried Decrease - -
Phase III risk of mortality
increase
Base risk of mortality
subclass plus maximum
13 Actual or Tried Decrease - -
Phase III risk of mortality
increase



subclass minus maximum
13 Actual Decrease 12,14,17 Actual Increase
Phase III decrease plus
one
13 Actual or Tried Decrease - - subclass minus maximum
Phase III decrease
10,12,14,17 Actual or Tried Decrease - - subclass plus maximum
Phase III increase
subclass minus maximum
10 Actual Decrease 11A,11B Actual Increase
Phase III increase plus
one
10 Actual or Tried Decrease - - subclass minus maximum
Phase III decrease
11A,11B Actual or Tried Increase - - subclass plus maximum
Phase III increase
11A,11B Actual or Tried Decrease - - subclass minus maximum
Phase III decrease

Patient Risk of Mortality Subclass Value : 1

Return to summary


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