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