Appendix A. Patient Cohorts and Related ICD-9-CM Codes
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Hospital Report CardsTM Methodology 9
May not be reprinted or reproduced without permission from Health Grades, Inc.
Patient Cohort
ICD-9-CM Procedure/Diagnosis Codes and Criteria
Partial Hip Replacement
Principal Procedures Inclusions:
81.52
Procedures Exclusions:
37.5, 37.51, 37.52, 37.53, 37.54, 78.65, 78.66, 78.67,
80.05, 80.06, 81.54, 81.55
Diagnoses Exclusions:
800.6, 820.10, 820.11, 820.12, 820.13, 820.19, 820.20,
820.22, 820.30, 820.31, 820.32, 820.9, 821.10, 821.11, 821.30, 821.31, 821.32,
821.33, 821.39, 996.4, V66.7
Peripheral Vascular Bypass
Principal Procedures Inclusions:
39.29
Principal Diagnoses Inclusions:
250.60, 250.61, 250.62, 250.63, 250.70,
250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 440.20, 440.21, 440.22,
440.23, 440.24, 440.29, 440.30, 440.32, 442.2, 442.3, 443.89, 443.9, 444.22,
444.81, 445.02, 445.05, 447.1, 681.10, 682.6, 682.7, 686.8, 707.10, 707.12,
707.13, 707.14, 707.15, 707.19, 707.8, 730.06, 730.07, 730.16, 730.17, 730.18,
730.26, 730.27, 785.4, 902.53, 904.41
Procedures Exclusions:
37.5, 37.51, 37.52, 37.53, 37.54, 37.62, 37.63, 39.25,
39.49
Diagnoses Exclusions:
440.31, 445.01
Prostatectomy
Principal Procedures Inclusions:
60.21, 60.29, 60.3, 60.4, 60.5, 60.61, 60.62,
60.69
Procedures Exclusions:
37.5, 37.51, 37.52, 37.53, 37.54, 37.62, 37.63
Pulmonary Embolism
Principal Diagnoses Inclusions:
415.11, 415.19
Procedures Exclusions:
37.5, 37.51, 37.52, 37.53, 37.54, 37.62, 37.63
Diagnoses Exclusions:
196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9,
197.0, 197.1, 197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198.0, 198.1, 198.2,
198.3, 198.4, 198.5, 198.6, 198.7, 198.8, 198.81, 198.82, 198.89, V66.7
Resection / Replacement of
Abdominal Aorta
Principal Procedures Inclusions:
38.34, 38.44, 38.64, 39.71
Procedures Exclusions:
35.10, 35.11, 35.12, 35.13, 35.14, 35.20, 35.21,
35.22, 35.23, 35.24, 35.25, 35.26, 35.27, 35.28, 36.1, 36.10, 36.11, 36.12, 36.13,
36.14, 36.15, 36.16, 36.17, 36.19, 37.5, 37.51, 37.52, 37.53, 37.54, 37.62, 37.63,
38.08, 38.16, 38.18, 38.36, 38.45, 39.24, 39.25, 39.29, 39.50, 39.59
Diagnoses Exclusions
: 441.00, 441.01, 441.02, 441.03, 441.1, 441.2, 441.6,
441.7, 441.9
Respiratory Failure
APR-DRG: 130, 133
Sepsis
Principal Diagnoses Inclusions:
003.1, 022.3, 027.0, 036.2, 036.3, 038.0,
038.10, 038.11, 038.19, 038.2, 038.3, 038.40, 038.41, 038.42, 038.43, 038.44,
038.49, 038.8, 038.9, 054.5, 785.52, 785.59, 995.90, 995.91, 995.92, 999.3
Procedures Exclusions
: 37.5, 37.51, 37.52, 37.53, 37.54, 37.62, 37.63
Diagnoses Exclusions
: 196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9,
197.0, 197.1, 197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198.0, 198.1, 198.2,
198.3, 198.4, 198.5, 198.6, 198.7, 198.8, 198.81, 198.82, 198.89, V66.7
