ICDTLB6B ;ALB/EG/MRY - GROUPER UTILITY FUNCTIONS FY 2006; 9/29/03 2:47pm ; 6/28/05 4:06pm ;;18.0;DRG Grouper;**20,22**;Oct 20, 2000;Build 1 DRG403 S ICDRG=$S(ICDPD["l":$S(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$S(ICDCC:401,1:402),ICDCC:403,1:404),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG404 S ICDRG=$S(ICDPD["l":$S(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$S(ICDCC:401,1:402),ICDCC:403,1:404),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG405 D DRG404 Q DRG406 ; I ICDORNI["K" D .S ICDRG=$S((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407) I ICDORNI'["K" D DRG408 Q DRG407 D DRG406 Q DRG408 I $D(ICDDX(1))&(ICDOPCT=0) D Q:ICDRG=409 .I ICDDX(1)=$O(^ICD9("AB","V58.0 ",0)) S ICDRG=409 Q .I ICDDX(1)=$O(^ICD9("AB","V67.1 ",0)) S ICDRG=409 Q .Q I $D(ICDDX(1))&(ICDOPCT=0) D Q:"410^492"[ICDRG .I ICDDX(1)=$O(^ICD9("AB","V58.11 ",0)) S ICDRG=$S(ICDSD["2":492,1:410) Q .I ICDDX(1)=$O(^ICD9("AB","V58.12 ",0)) S ICDRG=$S(ICDSD["2":492,1:410) Q .I ICDDX(1)=$O(^ICD9("AB","V67.2 ",0)) S ICDRG=$S(ICDSD["2":492,1:410) Q I ICDOPCT>0 S ICDRG=$S(ICDPD'["L":408,ICDCC:401,1:402) Q I ICDOPCT=0 D DRG412 Q DRG411 S ICDRG=$S(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N":412,1:411) Q DRG412 ;S ICDRG=$S(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N"&($D(ICDPDRG(412))):412,$D(ICDPDRG(411)):411,ICDCC:413,1:414) I ICDOPCT>0 D DRG408 Q D DRG412^ICDTLB61 Q DRG413 S ICDRG=$S(ICDCC:413,1:414) Q DRG414 S ICDRG=$S(ICDCC:413,1:414) Q DRG416 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:416,1:417),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG417 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:416,1:417),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG418 S ICDRG=$S(ICDOR["O":415,1:418) Q DRG419 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG420 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG421 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:421,1:422),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG422 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:421,1:422),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q DRG423 S ICDRG=$S(ICDOR["O":415,1:423) Q DRG424 S ICDRG=$S(ICDOR["O":424,1:425) Q DRG425 S ICDRG=$S(ICDOR["O":424,1:425) Q DRG426 S ICDRG=$S(ICDOR["O":424,1:426) Q DRG427 S ICDRG=$S(ICDOR["O":424,1:427) Q DRG428 S ICDRG=$S(ICDOR["O":424,1:428) Q DRG429 S ICDRG=$S(ICDOR["O":424,1:429) Q DRG430 S ICDRG=$S(ICDOR["O":424,1:430) Q DRG431 S ICDRG=$S(ICDOR["O":424,1:431) Q DRG432 S ICDRG=$S(ICDOR["O":424,1:432) Q DRG434 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q DRG435 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q DRG436 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q DRG437 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q DRG439 S ICDRG=$S($D(ICDODRG(440)):440,1:439) Q DRG442 S ICDRG=$S(ICDCC:442,1:443) Q DRG443 D EN1^ICDDRG5 S ICDRG=$S(ICDCC3:$S(ICDCC:442,1:443),1:"") Q DRG444 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG445 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG446 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG447 S ICDRG=$S(AGE>17:447,1:448) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG448 S ICDRG=$S(AGE>17:447,1:448) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG449 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG450 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG451 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3 Q DRG452 S ICDRG=$S(ICDCC:452,1:453) Q DRG453 S ICDRG=$S(ICDCC:452,1:453) Q DRG454 S ICDRG=$S(ICDCC:454,1:455) Q DRG455 S ICDRG=$S(ICDCC:454,1:455) Q DRG462 S ICDRG=$S(ICDOR["O":461,1:462) Q DRG463 S ICDRG=$S(ICDOR["O":461,ICDCC:463,1:464) Q DRG464 S ICDRG=$S(ICDOR["O":461,ICDCC:463,1:464) Q DRG465 S ICDRG=$S(ICDOR["O":461,ICDSD["m":465,1:466) Q DRG466 S ICDRG=$S(ICDOR["O":461,ICDSD["m":465,1:466) Q DRG467 S ICDRG=$S(ICDOR["O":461,1:467) Q DRG471 S ICDRG=$S($F($P(ICDOR,"M",2,99),"M"):471,1:"") Q DRG475 S ICDRG=$S(ICDOR["V":475,1:$S($D(ICDPDRG):$O(ICDPDRG(0)),1:468)) I ICDRG<468 D DODRG^ICDDRG0 Q DRG478 S ICDRG=$S(ICDOR["O"&ICDCC:478,1:479) I ICDRG=478 D DRG553^ICDTLB6B Q DRG479 G DRG478 DRG493 ;I (ICDI-1)=1,'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0) S ICDRG=$S(ICDCC:493,1:494) Q DRG494 ;I (ICD-1),'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0) S ICDRG=$S(ICDCC:493,1:494) Q DRG495 Q DRG496 S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) I ICDRG=497!(ICDRG=498) I ICDPD["6" S ICDRG=546 Q I ICDRG=497!(ICDRG=498) I $D(ICDDXT("737.40"))!($D(ICDDXT("737.41")))!($D(ICDDXT("737.42")))!($D(ICDDXT("737.43"))) S ICDRG=546 Q DRG497 G DRG496 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q DRG498 G DRG496 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q DRG499 S ICDRG=$S(ICDCC:499,1:500) Q DRG500 S ICDRG=$S(ICDCC:499,1:500) Q DRG501 D . I (ICDPD["k") D .. I ICDCC S ICDRG=501 .. I 'ICDCC S ICDRG=502 . E S ICDRG=503 Q DRG502 D DRG501 Q DRG503 D DRG501 Q DRG514 ; Replaced with DRG535 N ICDE1,ICDE2 S ICDE1=$S($D(ICDOP(" 37.95"))&($D(ICDOP(" 37.96"))):1,1:0) S ICDE2=$S($D(ICDOP(" 37.97"))&($D(ICDOP(" 37.98"))):1,1:0) S ICDRG=470 I $D(ICDOP(" 37.94")) I ICDE1+ICDE2=0 S ICDRG=515 I '$D(ICDOP(" 37.94")) I ICDE1!ICDE2 S ICDRG=515 ; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58 I ICDRG=515 I ICDOR["HN" S ICDRG=514 Q DRG515 D DRG535 Q DRG516 ; DRG 516,517,526 and 527 replaced by DRG 555-558 respectively S ICDRG=518 D DRG555 I $D(ICDOP(" 36.06"))!$D(ICDOP(" 92.27")) D DRG556 I $D(ICDOP(" 36.07")) D DRG557 Q DRG517 D DRG516 Q DRG518 D DRG516 Q DRG519 S ICDRG=$S(ICDOR["F":496,ICDCC:519,1:520) Q DRG520 D DRG519 Q DRG521 S ICDRG=$S(ICDCC:521,ICDOR["D"!(ICDOR["R"):522,1:523) Q DRG522 D DRG521 Q DRG523 D DRG521 Q DRG526 D DRG516 Q DRG527 D DRG516 Q DRG531 S ICDRG=$S(ICDCC:531,1:532) Q DRG532 D DRG531 Q DRG533 S ICDRG=$S(ICDCC:533,1:534) Q DRG534 D DRG533 Q DRG535 N ICDE1,ICDE2,ICDE3 S ICDE1=$S($D(ICDOP(" 37.95"))&(($D(ICDOP(" 37.96")))!($D(ICDOP(" 00.54")))):1,1:0) S ICDE2=$S($D(ICDOP(" 37.97"))&(($D(ICDOP(" 37.98")))!($D(ICDOP(" 00.54")))):1,1:0) S ICDE3=$S($D(ICDOP(" 00.52"))&($D(ICDOP(" 00.54"))):1,1:0) ;S ICDE4=$S($D(ICDOP(" 00.54"))&($D(ICDOP(" 37.95"))):1,1:0) S ICDRG=470 I $D(ICDOP(" 37.94"))!$D(ICDOP(" 00.51")) I ICDE1+ICDE2+ICDE3=0 S ICDRG=515 I '$D(ICDOP(" 37.94"))&('$D(ICDOP(" 00.51"))) I ICDE1!ICDE2!ICDE3 S ICDRG=515 ; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58 I ICDRG=515 I ICDOR["HN" I '$D(ICDOP(" 37.26")) S ICDRG=$S(ICDPD["A":535,1:536) I ICDRG=470 D DRG115^ICDTLB2B Q DRG536 D DRG535 Q DRG537 S ICDRG=$S(ICDCC:537,1:538) Q DRG538 D DRG537 Q DRG539 I ICDPD["L"&(ICDMAJ'[3) D DRG401^ICDTLB5B Q:"401^402^403^404^405^470^473"[ICDRG S ICDRG=$S((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407) Q DRG540 D DRG539 Q DRG543 S ICDRG=$S((ICDPD["Q")&(ICDOR["Q"):543,ICDOR["Q"&$D(ICDOP(" 00.10")):543,1:ICDRG) Q DRG544 Q DRG545 Q DRG546 Q DRG547 ; called from DRG106^ICDTLB2B D MCV S ICDRG=$S(ICDMCV:547,ICDMCV1:547,1:548) Q DRG548 G DRG547 DRG549 ; called from DRG106^ICDTLB2B D MCV S ICDRG=$S(ICDMCV:549,ICDMCV1:549,1:550) Q DRG550 G DRG549 DRG551 ; called from DRG115^ICDTLB2B D MCV I ICDMCV!(ICDMCV2) S ICDRG=551 Q DRG552 Q DRG553 ; called from DRG478 D MCV S ICDRG=$S(ICDMCV:553,ICDMCV1:553,1:554) Q DRG554 G DRG553 DRG555 ; called from DRG516 D MCV I ICDMCV!(ICDMCV1) S ICDRG=555 Q DRG556 ; called from DRG516 D MCV I 'ICDMCV&('ICDMCV1) S ICDRG=556 Q DRG557 ; called from DRG516 D MCV I ICDMCV!ICDMCV1 S ICDRG=557 E S ICDRG=558 Q DRG558 G DRG516 DRG559 ;I DGDX(1)["433.01"!(DGDX(1)["433.11")!(DGDX(1)["433.21")!(DGDX(1)["433.31")!(DGDX(1)["433.81")!(DGDX(1)["433.91")!(DGDX(1)["434.01")!(DGDX(1)["434.11")!(DGDX(1)["434.91") S ICDRG=559 I $G(ICDDX(1))=12856!($G(ICDDX(1))=12858)!($G(ICDDX(1))=12860)!($G(ICDDX(1))=12862)!($G(ICDDX(1))=12864)!($G(ICDDX(1))=12866)!($G(ICDDX(1))=12868)!($G(ICDDX(1))=12870)!($G(ICDDX(1))=12872) S ICDRG=559 Q MCV ; checks to see if case qualifies as an MCV (major cardiovascular complications or complex conditions) S (ICDMCV,ICDMCV1,ICDMCV2)=0 ; ICDPD=identifier for prime dx ICDSD=identifier for any secondary dx ; DGDX(1)=prime dx ICDDX(1)=ien of prime dx ICDDXT=any secondary dx I ICDPD["c"!(ICDSD["c") S ICDMCV=1 I ICDSD["s" S ICDMCV=1 ;I DGDX(1)["426.0"!(DGDX(1)["426.53")!(DGDX(1)["426.54") S ICDMCV1=1 I $G(ICDDX(1))=9056!($G(ICDDX(1))=2548)!($G(ICDDX(1))=2549) S ICDMCV1=1 I $D(ICDDXT("426.0"))!($D(ICDDXT("426.53")))!($D(ICDDXT("426.54"))) S ICDMCV1=1 ;I DGDX(1)["411.1"!(DGDX(1)["411.81") S ICDMCV2=1 I $G(ICDDX(1))=2500!($G(ICDDX(1))=12477) S ICDMCV2=1 I $D(ICDDXT("411.1"))!($D(ICDDXT("411.81"))) S ICDMCV2=1 Q